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Outcomes in distal hypospadias

Balanescu R.N., Niculescu Laura, Balanescu Laura, Moga Andreea
Abstract: Hypospadias is one of the most common congenital malformations of the external male genitalia, in which the urethra opens ventrally, anywhere from the glans to the perineum, the penis has an incompletely formed prepuce and may exhibit ventral curvature. Many surgical techniques for the reconstruction of this defect have been devised, each one having a different success rate. The aim of our study is to determine the complication rates and predictive factors for Mathieu and tubularized incised plate (TIP) techniques used in the repair of distal hypospadias. We assessed 62 patients diagnosed with distal hypospadias that were subjected to surgical correction by using either Mathieu or TIP urethroplasty during January 2011 and December 2012 in our clinic. The patients were divided into two groups according to the surgical technique which was performed. Urethroplasty complications, defined as fistula, urethral stricture and dehiscence, were statistically analyzed. There were 23 patients operated using the Mathieu technique and 39 patients using TIP repair. Mean age of presentation was 14 months for the Mathieu group and 20 months for the TIP groups. The urethral complication rate was slightly lower for the Mathieu group than in those cases solved by using the TIP technique (17.39% vs. 23.07%). There was just one case who presented with postoperative fistula in a patient belonging to the Mathieu group, while 5 patients operated with the TIP technique presented urethral stricture. No such cases were reported in the Mathieu group. Dehiscence was present in both groups (13.04% in the Mathieu group vs. 10.25% in the TIP group). We conclude that both techniques are acceptable and effective for the treatment of distal hypospadias, with complication rates being similar in the two groups.

Keywords: Mathieu, complications, Snodgrass


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