OBJECTIVE: To assess the efficacy of local volume reduction of the dorsal glans groove in hypospadias repair with small glans. METHODS: This retrospective comparative study included 107 children treated between January 2017 and December 2020. Patients were divided into two groups: Group 1 (2017-2018) underwent onlay island flap urethroplasty alone, while Group 2 (2019-2020) underwent the procedure with additional local volume reduction of the dorsal glans groove. Hypospadias objective scoring evaluation (HOSE) scores and postoperative complications, including glans dehiscence, meatal stenosis, and urethrocutaneous fistula, were compared. RESULTS: The mean follow-up was 40 months (Group 1) and 32 months (Group 2). Urethrocutaneous fistula rates were 4% (Group 1) and 2% (Group 2
P = 1). Glans dehiscence occurred in 16% (Group 1) and 4% (Group 2
P = 0.0451). Meatal stenosis rates were 16% (Group 1) and 2% (Group 2
P = 0.0184). Overall success rates were 65% (Group 1) and 92% (Group 2
P = 0.0008). HOSE scores showed no significant difference (P = 0.219). CONCLUSIONS: Local volume reduction of the dorsal glans groove significantly reduces postoperative complications in hypospadias repair with small glans.