Megameatus intact prepuce with distal megalourethral dilatation: A case report and review of the literature

Abstract

Introduction: Megameatus Intact Prepuce is a rare and often under-recognised variant of distal hypospadias, as the normal-appearing foreskin may mask the underlying urethral abnormality.

Case Presentation: We report the case of a male neonate who presented with voiding difficulty and preputial ballooning, in whom Megameatus Intact Prepuce was identified during an attempted circumcision. The child subsequently underwent hypospadias repair at eight months of age. Intraoperative findings revealed a subcoronal megameatus with associated distal megaurethral dilatation extending to the mid-penis. Redundant urethral tissue was excised, and tubularised plate urethroplasty was performed with a satisfactory outcome.

Conclusion: This report highlights the anatomical variability of Megameatus Intact Prepuce and the importance of careful clinical assessment and tailored surgical management to achieve favourable outcomes.