Do patch procedures prevent complications of the Mathieu technique?
OBJECTIVE
The effects of V-incision sutured (MAVIS) and dartos patch reinforcement techniques in reducing side effects and complications of the Mathieu procedure and improving the appearance of the meatus are evaluated.


METHODS
A total of 74 patients with distal shaft hypospadias without chordee or with minimal chordee were operated on by a single surgeon using Mathieu's technique. While only the classic Mathieu repair was performed in group 1, MAVIS and dorsal dartos patch reinforcement was included with the procedure in group 2. A silicone urethral catheter and foam silicone dressing were used in both patient groups.


RESULTS
There were 32 cases in group 1 and 42 in group 2. Median patient age at operation was 3.2 and 3.4 years in groups 1 and 2, respectively. Mean postoperative period for the silicone catheter was 4.9 days in both groups. Followup ranged from 52 to 128 months (mean 76) for group 1 and 13 to 43 months (25.4) for group 2. Five fistulas and 1 meatal stricture developed in group 1 and all the children in this group required meatal calibration with dilatation in some. Neither fistula nor stricture occurred in group 2 and there was no need for calibration. A slit-like meatus was achieved in all children in group 2 but in only 12 in group 1.


CONCLUSIONS
The MAVIS technique and dorsal dartos patch reinforcement may prevent complications of the classic Mathieu procedure. A slit-like meatus was obtained in all cases with this approach.
Yesildag
Ebru
E
Department of Paediatric Surgery, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey.
Tekant
Gonca
G
Sarimurat
Nuvit
N
Buyukunal
S N Cenk
SN
D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D010413:Penis / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000379:methods*