title: Mathieu urethroplasty as a salvage procedure: 20-year experience.
abstract: OBJECTIVE
  We assessed the results of the Mathieu procedure in a series of patients who had undergone multiple prior hypospadias repairs.
  
  
  METHODS
  Medical records of 55 boys who underwent repeat surgery with the Mathieu procedure were retrospectively reviewed. Prior surgeries, level of hypospadias defect, number of prior surgeries and complications were recorded. Statistical analyses were performed on factors that would impact the outcome.
  
  
  RESULTS
  Mean patient age at the time of the salvage Mathieu procedure was 10.33 years (range 2 to 30). In 14 of the 55 patients (25.4%) fistula occurred following the salvage repair. Complications were split glans in 1 case, skin dehiscence in 1 and complete breakdown of the repair in 1. Fistula formation did not differ in groups categorized according to the level of the urethral meatus. Fistula occurred in 6 of 37 (16.2%) and 8 of 18 (44.4%) boys who underwent 1 and more than 1 prior surgery, respectively (p = 0.04).
  
  
  CONCLUSIONS
  Although the Mathieu operation had a favorable outcome (74.6% cure) as a salvage procedure in 1 stage, fistula occurred more frequently as the number of prior surgeries increased. Therefore, if primary surgery fails, repeat operation should be performed by an experienced "hypospadiologist."
authors.affiliation: Clinic of Urology, Ankara Teaching and Research Hospital, Ministry of Health, Ankara, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Emir
authors.forename: Demokan
authors.initials: D
authors.lastname: Erol
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D010409:Penile Diseases / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D014521:Urethra / Q000601:surgery*; D014522:Urethral Diseases / Q000209:etiology / Q000601:surgery; D014548:Urinary Fistula / Q000209:etiology / Q000601:surgery