title: Stent-free Thiersch-Duplay hypospadias repair with the Snodgrass modification.
abstract: OBJECTIVE
  Incision of the glanular urethral plate (the Snodgrass modification) permits tubularization of the neourethra in the Thiersch-Duplay fashion when anatomy would otherwise preclude a tension-free anastomosis and necessitate another operative technique for hypospadias repair. To take advantage of these cosmetic benefits without the potential morbidity associated with indwelling catheters, we performed a stent-free Thiersch-Duplay repair incorporating the Snodgrass modification.
  
  
  METHODS
  The Thiersch-Duplay hypospadias repair was combined with the Snodgrass modification. Hinging the urethral plate was necessary when the glanular groove was too shallow to perform a standard Thiersch-Duplay repair.
  
  
  RESULTS
  Stent-free repairs were performed in 33 children 0.47 to 2.66 years old (mean age plus of minus standard deviation 0.98 +/- 0.47). Followup was obtained in 31 children. There was no postoperative urinary retention, fistulas or meatal stenosis. No unusual or prolonged discomfort distinguished these children from those who underwent a standard Thiersch-Duplay repair.
  
  
  CONCLUSIONS
  Excellent cosmetic results can be anticipated irrespective of the preoperative glans configuration. Incision of the glanular urethral plate can be performed safely as an adjunct to a modified Thiersch-Duplay hypospadias repair without postoperative indwelling catheters.
authors.affiliation: Children's Urology Group, Tampa, Florida, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Steckler
authors.forename: M R
authors.initials: MR
authors.lastname: Zaontz
mesh_terms: D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D013514:Surgical Procedures, Operative / Q000379:methods; D014521:Urethra / Q000601:surgery*