- Aim of the work: To describe the abnormal anatomy met with cases of distal hypospadias and to compare the results of
- different techniques of its repair
- Patients and methods.
- 40 patients with distal hypospadias underwent surgical repair in the period from Oct 2004 to Oct 2005
Three operative procedures was used:
– Tubularized incised plate urethroplasty (Snodgrass)(TIP),
–Meatal based flap (Mathieu) repair
–(Meatal advancement and glanuloplasty incorporated technique (MAGPI)
Results:
- The age ranged from 6 months to 12 years
- Pin hole meatus was the commonest finding to be present in association with hypospadias (12.5%)
- Edema was the most common complication in the early postoperative period:
–83% in Mathieu
–80% in TIP
–75% in MGAPI
- Fistula was the most important chronic complication of hypospadius repair:
–4 out of 20 cases with TIP repair
–3 out of 12 cases with Mathieu repair
–one out of 8 cases with MAGPI repair
Conclusion:
- TIP urethroplasty (Snodgrass) repair showed the best outcome in comparison with Mathieu technique for repair of coronal and distal penile hypospadias
- It has the following advantages:
–fewer overall complications rate
–lower operative time
–better cosmetic appearance of the neomeatus
- The outcome of hypospadias repair depends on the following:
–good dissection and excision of chordee if found
–fine handling of tissue
–the use of fine suitable and adequately tissue coverage without tension