ABSTRACT
The aim of this study is to evaluate alternative techniques in repair of different types of primary hypospadias, with suggested plan for decision making of suitable technique of repair. A retrospective study of 96 cases of primary distal hypospadias [glandular, coronal, distal penile with and without chordee] were performed over a period of three years, with a minimum follow up of six months. Methods of repar included MAGPI [40], extended MAGPI [12], Mathieu [24], modified Mathieu [4], tubularised uretheral plate [9] and preputial tubed island flap [7]. The results revealed that, MAGPI [40 patients] had no major complications in glandular type and 12.5% complication rate in coronal. Extended MAGPI [12 patients] had complication rate of 37.5% in distal penile. Classic Mathieu [24] had 15% complication rate and modified Mathieu [4 patients] 25% major complication in distal penile with chordee. Tubularised uretheral plate [9 patients] had 22.2% complication rate for coronal and distal penile. Preputial island flap [7] had 28.5% complication rate in distal penile with chordee. Total major complication rate was 15.6%. Best results were obtained from proper technique selection for different types of distal hypospadias. Decision making of proper technique depends on meatal location and variety, presence of chordee, gland configuration [flat or conical], uretheral plate [flat or grooved and/or a seat of chordee] and availability of shaft or preputial skin