This study was designed to evaluate outcome of the Meatal-based Flap "Mathieu" Technique versus
Tubularized Incised Plate "Snodgrass", for distal hypospadias repair in children, the study included 34
children with mean age of) 7.5±4.8 months and had distal hypospadias with good prepucial hood and mild
chordee (<30°). Patients were randomly classified into two groups. Group I underwent Snodgrass
technique with spongeoplasty (S group; n=17), while group 2 underwent Mathieu technique (M group;
n=17). Operative time and times till transurethral catheter removal, and till hospital discharge, the
frequency of postoperative (PO) complications were reported and compared. At 6-months postoperatively,
parents were inquired about their satisfaction about the cosmetic appearance of the penis and the shape of
the uretheral meatus, the mean operative time, durations of urethral stenting and of hospital stay showed
non-significant difference between both procedures. Three patients developed urethrocutaneous fistula; 2
in group2 and one in groupl and 4 patients, 2 in each group had meatal stenosis with significantly higher
success rate in group I (82.4%) compared to group2 (76.5%). Patients developed fistula had redo
Snodgrass with dartos fascia coverage, irrespective of the first technique, 6 months after the initial repair
and all of the 3 cases had successful redo surgery. One patient had meatal stenosis in group2 that required
operative slit-opening of the stenosed meatus, while the other 3 patients responded to frequent dilatation.
As regards parents' satisfaction, the frequency of high satisfaction scores and the total satisfaction score
were significantly higher in S group compared to M group, it could be concluded that Snodgrass technique
with spongeoplasOi was advantageous with significantly higher success rate and better cosmetic results
inducing significantly higHer parents' satisfaction rate. Moreover, Snodgrass technique with dartos fascia
coverage is applicable for redo cases with high success rate.
Keywords: hypospadias, " Snodgrass" , "Mathieu", urethral plate |
