I found one case with complete prepuce and coronal hypospadias
Of course, it is posible. Surgeon should be aware this type of hypospadias to avoid circumcision.
The most common type of hypospadias with intact prepuce is the variant known as megameatus-intact prepuce. There are several published articles in the literature, and also you can find a book chapter (Megameatus intact prepuce hypospadias variant written by Amir F. Azmy in Hypospadias Surgery: An Illustrated Guide, eds: Hadidi A, Azmy AF) which explains main points of surgical approach.
MIP is an unusual, anterior hypospadias variant characterized by a widely splayed coronal or subcoronal meatus, a deep glanular groove, a normally conformed prepuce, and no chordee.
Several approaches are used for MIP repair, including the glanular approximation procedure (GAP), the pyramid procedure, cutaneous advancement procedure, and the subcuta- neous frenulum flap with many modifications or the classic tip
Yes of course, It depend on the location of the hypospadia.
That is the reseason why many clinicians should be aware of distal hypospadia before doing circumcision.
Yes, I have seen a few with glanular and coronal hypospadias with intact prepuce. These patients also had very minimal or no chordee and as such careful examination is required at circumcision to avoid the procedure until after a urethroplasty is performed.
It can also happen in epispadias / bi-valved glans cases. Figure 13.3 in the Text Atlas of Penile Surgery shows such a case. .Fig. 13.10 A-C describes its repair. (Chapter 13 on Epispadias. pp. 107-114. by D. Yachia. Informa Healthcare, London.UK 2007)
The characteristics of the megameatus intact prepuce (MIP) hypospadias variant present a unique challenge to surgeons. Dissatisfaction with the results of conventional repair methods led to the emergence of several alternative surgical approaches, including the glanular approximation (GAP) and pyramid procedures. The application of tubularized, incised plate (TIP) urethroplasty has been documented in this setting.
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