Primary and salvage urethroplasty using Mathieu meatal-based flip-flap technique for distal hypospadias.
BACKGROUND
Numerous surgical procedures have been attempted for correction of distal hypospadias. The Mathieu procedure was employed in this study for secondary cases as well as primary cases.


METHODS
The length of the skin flap is determined by measuring the distance from the meatus to the glans tip and then the ventral meatal-based skin flap is incised. The proximal skin flap is flipped and anastomosed to the distal urethral plate. Additionally, subcutaneous tissue of the flipped flap is sutured to cover the original suture lines completely.


RESULTS
The Mathieu urethroplasty was successful in one stage in 13 of the 16 primary repair cases (81%). Twelve of the 13 (92%) who underwent a secondary Mathieu procedure were successfully repaired with no problems. An overall success rate of 86% was achieved at the first operation for both primary and secondary cases. In the remaining 14% of the cases, success was achieved with only one additional procedure.


CONCLUSIONS
The Mathieu flip-flap procedure is feasible for relatively short urethral defects if the ventral penile skin demonstrates adequate mobility and there is no chordee. Even in patients who require revisional hypospadias surgery, the Mathieu procedure can give excellent functional and cosmetic results.
Hayashi
Y
Y
Department of Urology, Nagoya City University, Medical School, Nagoya, Japan. yutaro@med.nagoya-cu.ac.jp
Sasaki
S
S
Kojima
Y
Y
Maruyama
T
T
Tozawa
K
K
Mizuno
K
K
Kohri
K
K
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000473:pathology / Q000601:surgery*; D007223:Infant; D008297:Male; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods