MATHIUE & SNODGRASS; COULD BOTH BE COMBINED?

El-Desouki, M; Khairi, A

doi:10.21608/ejsur.2004.374038

MATHIUE & SNODGRASS; COULD BOTH BE COMBINED?

Document Type : Original Article

Authors

Pediatric Surgery Department, Alexandria Faculty of Medicine, Alexandria, Egypt.

10.21608/ejsur.2004.374038

Abstract

Objective: To review a new technique for correcting distal-to-mid penile hypospadias where we combined both Mathiue' & Snodgrass techniques.
Material & Methods: From May 2000 to May 2001, 10 boys (mean age= 6years) were treated for mid-to-distal penile
hypospadias at the pediatric surgery unit, Alexandria faculty of medicine using a new technique where we combined both Mathieu and Snodgrass techniques.
After the two parallel incisions on both sides of the urethral plate were made, they were carried out proximally for an equal distance to that one from the urethral meatus to the glans tip. The urethral plate was incised as usual in Snodgrass and the proximal flip flap raised and sutured to the edges of the urethral plate as usual in Mathiue. The width of the proximal flap was as little as 5 mm. A second layer from the prepuce subcutaneous tissue or from local tissue were laid over the tube which was stented with an 8 or 10 Fr soft tube for 5-7 days. The mean follow up was 6 months.
Results: The 10 boys were stented; 2 for 5 days and 8 for 7 days.3 cases (30%) developed a urethro-cutaneous fistula. 4 cases (40%) were already circumcised and 6 (60%) were circumcised during the same procedure. 2 cases (20%) developed meatal stenosis and one case (10%) had partial repair disruption.
Conclusion: Combined Mathiue and Snodgrass repair for correction of Mid-to-distal penile hypospadias is a reliable method.
It suits cases where the urethral plate is narrow and at the same time allows the use of a smaller flip flap when the proximal skin condition does not allow for the usual flap size.

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