title: Mathieu and Barcat repair with a V incision sutured meatoplasty for secondary hypospadias surgery.
abstract: OBJECTIVE
  Today single-stage methods are more frequently selected for hypospadias repair than multistaged methods, but complications cannot always be avoided. We employed two kinds of meatal based flip-flap urethroplasty procedures for those with an unsuccessful primary hypospadias repair.
  
  
  METHODS
  From 1997 to 2005, a meatal based flip-flap urethroplasty was performed as a secondary hypospadias surgery on 17 patients. Basically we attempted the Mathieu repair, but when the wings of the glans were not generously widened and the urethral groove was not sufficiently deep we applied the Barcat procedure. While 11 patients were repaired with the Mathieu technique, six patients underwent the Barcat repair. The V incision sutured meatoplasty was added to obtain a natural ventral slit-like meatus.
  
  
  RESULTS
  Ten of the 11 patients who underwent the Mathieu repair had a good outcome, but one patient developed a urethrocutaneous fistula. None of the six patients repaired with the Barcat procedure encountered postoperative complications. Cosmetically, a vertical slit was constructed near the normal neomeatus with the Mathieu and V incision sutured (MAVIS) meatoplasty and the Barcat and V incision sutured (BAVIS) meatoplasty.
  
  
  CONCLUSIONS
  The Mathieu or the Barcat meatal based flip-flap urethroplasty procedure is feasible as a salvage surgery for those with relatively short urethral defects and adequate mobile ventral skin if an exact procedure is selected. Excellent cosmetic results could be obtained by adding the technique of V incision sutured meatoplasty.
authors.affiliation: Nagoya City University Graduate School of Medical Sciences, Department of Nephro-urology, Nagoya, Japan. yutaro@med.nagoya-cu.ac.jp
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kojima
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mizuno
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nakane
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Maruyama
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
mesh_terms: D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture; D013521:Urologic Surgical Procedures, Male / Q000379:methods