Comparative Study betweenTubularized Incised Plate (Snodgrass) Urethroplasty and Reverse Flap (Mathieu’s) Repair in Distal Hypospadias

Objectives: To compare results of Tubularized incised plate urethroplasty (Snodgrass) and Mathieu’s repair in distal hypospadias repair. Study Design: Experimental Study. Place and Duration: Department of Urology and Renal Transplantation, Quaid-I-Azam Medical College /Bahawal Victoria Hospital, Bahawalpur, from April 2008 to October 2010. Materials and Methods: A total of sixty four patients, 1.5 to 25 years of age were included in the study. Patients of Distal Penile Hypospadias with significant chordae and history of previous surgery were excluded. Patients were divided in two groups, 32 patients in each group. Group I had Tubularized Incised Plate Urethroplasty and Group II had Mathieu’s repair. Operative time was noted for both the procedures separately. Patients were followed for subsequent outcome. Complications were noted as immediate postoperative (within 24 hours), delayed post-operative (within 72 hours) and on follow up. Results: The mean duration of surgery was significantly lower for Tubularized incised plate urethroplasty as compared to Mathieu’s repair. Only two patients undergoing Tubularized Incised Plate Urethroplasty had complications as compared to seven patients undergoing Mathieu’s repair. Cosmetic results were excellent with Tubularized Incised Plate Urethroplasty with a normal slit like meatus and appearance of glans. Conclusion: The overall complication rate and operative time were significantly lower in Tubularized Incised Plate urethroplasty, which also had a better cosmetic outcome. Therefore we recommend this repair as a primary treatment for distal hypospadias.