Comparison of Outcome Complications between Snodgrass Technique and Mathieu’s Repair in Distal Hypospadias Repair

Abstract

Objective: To compare the outcome of complications between Snodgrass technique and Mathieu’s repair in distal hypospadias repair.

Study Design: Randomized controlled Study.

Place and Duration of Study: This study was conducted at the Department of Pediatric Surgery, Bahawal Victoria Hospital, in collaboration with plastic surgery department and pathology department, Quaid-e-Azam Medical College Bahawalpur, from January 2019 to December 2020 over the period of 2 years.

Materials and Methods: Total 148 patients with sub-coronal and distal penile hypospadias having age 2-8 years were selected. Snodgrass technique was performed for Group A patients while Mathieu’s repair was done for Group B patients.  Post-operative complications were compared between the two groups.

Results: Mean age of the patients was 5.07 ± 1.73 years, mean age of patients of study group A was 4.96 ± 1.66 years and group B was 5.19 ± 1.78 years.  In 6 (8.11%) patients of study group A and 21 (28.38%) patients of study group B, meatal stenosis was noted and difference of frequency of meatal stenosis between the both groups was statistically significant with p- value of 0.001.  Total 5 (6.76%) patients of study group while 15 (20.27%) patients of study group B found with urethral stricture and the difference was statistically significant with p-value of 0.016.  Urethrocutaneous fistula was found in 2 (2.70%) patients of study group A and in 9 (12.16%) patients of study group B.  Difference of frequency of Urethrocutaneous fistula between the both groups was statistically significant with p-value of 0.028.  Complete repair disruption was noted in 7 (9.46%) patients and 17 (22.97%) patients respectively in study group A and study group B and difference was statistically significant with p value 0.026.

Conclusion: Our study has revealed that TIP urethroplasty has an edge on Mathieu’s urethroplasty, so we recommend the TIPurethroplasty in all primary and distal cases of hypospadias. TIP repair is associated with excellent cosmetics and few manageable complications. It offers a safe and reliable modality for primary repair of distal penile hypospadias. Cosmetic appearance of the external urethralmeatus is highly satisfactory with tubularized incised plate urethroplasty.