ABSTRACT
To determine whether the tubularized incised plate urethroplasty [Snodgrass] or the perimeatal-based flap [Mathieu] is the more appropriate treatment of distal hypospadias in terms of complication rate, operative time duration and cosmesis of the meatus. Between January 1999 and May 2000, 60 children having primary distal hypospadias were randomized in two equal groups. Thirty patients underwent tubularized incised plate urethroplasty [Snodgrass] and thirty underwent a penmeatal-based flap [Mathieu]. The operative time duration, cosmesis of the meatus as well as the complication rate of both techniques are determined. The mean duration of surgery was significantly lower for Snodgrass procedure than for Mathieu repair [90 vs. 130min, P < 0.05]. Four children undergoing Mathieu repair had complications [13%] compared with only one in the Snodgrass Group [3.3%]. The resultant meatus was slit-like in patients undergoing Snodgrass whereas those with Mathieu had a rounded or horizontal meatus. The overall complication rate was lower and the surgery was significantly quicker with the Snodgrass, which also had a better cosmetic outcome. The Snodgrass procedure could be recommended as a primary treatment for distal hypospadias