[Comparison of the Mathieu and the Snodgrass urethroplasty in distal hypospadias repair]

Abstract

Objective: To compare the success rate, postoperative complications and cosmetic appearance of the perinatal flap (Mathieu) and the tubularized incised-plate (Snodgrass) urethroplasty in distal hypospadias repair.

Methods: Between March 2001 and April 2004, Snodgrass-type repair was done in 36 patients and Mathieu-type repair in 43 patients with primary hypospadias either with or without minimal chordee.

Results: The mean duration of surgery was significantly shorter for the Snodgrass procedure than for the Mathieu repair. With 3-10 months follow-up, the total numbers of complications of Snodgrass repair and Mathieu repair were 8 (22.2%) and 16 (37.2%) (P > 0.05), the fistula formation rates 8.3% and 25.6%, the meatal stricture formation rates 5.6% and 2.3%, and the wound dehiscence rates 8.3% and 2.3%, respectively. Flap necrosis was seen in 3 cases in the Mathieu group. Cosmetic appearance was highly satisfactory in the Snodgrass group.

Conclusion: The fistula and flap necrosis rates were lower and the surgery more convenient with the Snodgrass urethroplasty, which also had a better cosmetic outcome. The Snodgrass technique is recommended as a primary treatment to substitute Mathieu repair for distal hypospadias with or without minimal chordee.