Comparative analysis of three urethroplasty techniques in patients with distal and penile forms of hypospadias

Rudin Yu.E., Maruhnenko D.V., Garmanova T.N., Sayedov K.M.

Introduction: The most common techniques for hypospadias surgical treatment in patients with distal and penile hypospadias (primary and secondary surgeries) are: tubularized incised plate (TIP) urethroplasty, grafted tubularized incised urethral plate urethroplasty, and Mathieu urethroplasty.

Materials and methods: We retrospectively evaluated the results of treatment of 135 boys with various forms of hypospadias in the period from 2010 to 2012, which were divided into 3 groups: TIP (n = 45), GTIP (n = 35), Mathieu urethroplasties and method of onlay (n = 55).

Results: In the first group complications (urinary fistula, and urethral stenosis) were observed in 8 patients (17.8%). In 80% of patients with urethral fistula there was a restriction of urethra near the glans. In the second group urethral fistula was observed in 5 kids (14.3%), urethral restriction was only in 1 boy, who had a tendency to increased scarring. All complications were observed in patients with middle penile forms of hypospadias. In the third group urethral fistulas were observed in 6 boys (10.9%). No signs of urethral restrictions near the glans were detected. Statistically significant differences in frequency of complications were found in patients of the first and third groups of patients, and the second and third groups.

Conclusion: The Snodgrass urethroplasty can be performed as a primary and as a secondary treatment option in patients with normal size of glans and urethral plate. However, in patients with changes in urethral plate, scarring and small size of glans it is more appropriately to perform Mathieu surgery.

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