Evaluation of the different technique for repair of distal hypospadias

ABSTRACT

Hypospadias is one of the most common congenital anomalies occurring in approximately 1520 to 1300 live births [Baskin, 2000]. Hypospadias in boys, may be defined classically as an association of the penis 1. An abnormal ventral opening of the urethral meatus, 2. An abnormal ventral curvature of the penis [chordee]; 3. An abnormal distribution of the foreskin, with a hood present dorsally and deficient foreskin ventrally [Mouriquand et al, 1950]. The aim of this work was to adequately describe the abnormal anatomy met with distal hypospadias cases and to evaluate the results of repair of distal hypospadias comparing the results of the different techniques of repair to be aware about the most suitable technique. This study was done on 40 patients with distal hypospadias in the age range 6 months to 12 years in the period from October 2004 to October 2005 in Plastic Surgery Department, Sohag university Hospital. Full history, clinical examination and routine investigations was done for every patients. We used three operative procedures a-Tubularized incised plate urethroplasty [Snodgrass] [TIP], be-Meatal based flap [Mathieu] repair, and c-Meatal advancement and glanuloplsty incorporated technique [MAGPI]. Pin hole meatus was the commonest finding to be present in association with hypospadias in this study [12.5%]. Edema is the most common complication in the early postoperative period; represent, 83% in Mathieu, 80% in TIP75% in MGAPL. As regard the chronic complication, fistula is the most important complication of hyospadius repair, it was recorded in 4 out of 20 cases with TIP repair, 3 out of 12 cases with Mathieu repair and one case out of 8 cases with MAGPI repair