Typical hypospadias: from the tip of the penis to the base: the ventral side of the head is split(I), the urethral plate replaces the urethra(2), from the tip of the head down to the ectopic urethral opening(3), behind the ectopic urethra is a segment of dysplastic urethra without cavernous encasement(4), and the cavernous part of the urethra(5) is the proximal end of the deformity. Here, we explain in detail how to choose the surgical method for hypospadias. The penis of hypospadias is not big, but in the small square inch, there are more than 300 kinds of surgical methods, and there are more than 10 kinds of common surgical methods, regardless of which surgical method, the first thing is to determine whether there is penile hypospadias, artificial erection test is an important method to determine whether there is penile hypospadias, if there is penile hypospadias, first correct penile hypospadias, and then do urethroplasty. The various types of hypospadias vary greatly, and a high degree of surgical delicacy is required, which should be combined with the characteristics of the baby’s hypospadias to tailor a personalized surgical plan. For different types of hypospadias, the common surgical options are as follows: 1, penile head, coronal sulcus type hypospadias, hypospadias without penile hypospadias or hypospadias that can be corrected without cutting off the urethral plate can be considered for MAGPI. The MAGPJ procedure is particularly suitable for cases with a wide and flattened penile head in thousands. 2. The Mathieu and Snodgrass procedures can be considered for coronal, subcoronal, and hypospadias where the urethral orifice is located in the first 1/3 of the penile body. In the Mathieu procedure, two parallel incisions are made along both edges of the urethral plate, up to the tip of the head of the penis and deep to the corpus cavernosum of the penis, producing a flap with the periphery of the external urethral opening as the base, which is flipped and sutured to both edges of the urethral plate. The flanks of the head of the penis were enlarged by incision with the corpus cavernosum of the penis and then sutured together to form a conical head of the penis. On the urethral plate, a longitudinal incision is made along the median line from the ectopic external urethral opening to the head of the penis, followed by suturing around the catheter to form a tube, which is known as the Snodgrass procedure. In the Onlay procedure, the rectangular foreskin mucosa with a vascular tip is freed down to the base of the penis, transferred to the ventral penis and covered on the urethral plate, and both edges are sutured with 6-0 or 7-0 sutures intermittently or continuously. 4.Urethral fissure with obvious penile recurvature after removal of the sleeve should be adopted by transverse cut foreskin flap and tubular urethroplasty (Duckett procedure). 5.Denis-Browne method is suitable for cases where penile hypospadias has been corrected or long segment urethral fistula. 6.Scrotal midline skin island flap method is suitable for hypospadias with prepuce, penile skin less scrotal longitudinal development. 7.Free graft substitution urethra is suitable for cases where there is not enough local tissue available for penile repair after multiple surgeries. The above mentioned is mainly a stage I urethroplasty, and there is another surgical method which is staged surgery, mainly for very serious hypospadias, first correcting the penile recurvature, forming a good part of the urethra, and paving the way for the next completed hypospadias surgery. Some of the content here is relatively difficult to understand (Dr. Huang has tried his best to describe it in an easy-to-understand way), it doesn’t matter if you don’t understand, choosing the right surgery is mainly a matter for the doctor, who will choose the right surgery according to the baby’s specific situation. A reasonable choice of surgical modality and skilled operation is a great test for pediatric surgeons, and is the key to doing well with hypospadias.