Urinary function after Snodgrass repair of distal hypospadias: comparison with the Mathieu repair.
OBJECTIVE
To evaluate urinary function in patients with distal hypospadias undergoing repair by the tubularized incised-plate urethroplasty (TIP or Snodgrass), compare the results with those in patients treated by the Mathieu technique, and show the potential issues inherent to the evaluation of such results.


METHODS
A cross-sectional assessment was performed of uncomplicated distal hypospadias operated on during a 3-year period, already toilet trained, and able to void volitionally. Evaluation included clinical assessment urinary symptoms and urinary stream, and uroflowmetry.


RESULTS
Out of 83 patients operated on during the study period, 10 (12%) developed complication and 32 were not toilet trained or refused to participate in the study. Median follow-up in the remaining 41 patients included in the study was 20 (3-36) months. None of these patients presented voiding symptoms or urinary stream abnormalities. Uroflowmetry was normal in 30 cases and obstructive in 11 (27%). An obstructive flow pattern was more common in patients undergoing TIP versus Mathieu repair, 8 of 19 (42%) versus 3 of 22 (14%), respectively (P = 0.07). Four TIP cases with an obstructive uroflow pattern were managed conservatively.


CONCLUSIONS
Although both the TIP and the Mathieu repair allow good results in terms of urinary function after distal hypospadias repairs, the TIP technique seems more likely to be associated with urine flow pattern abnormalities. The actual clinical relevance of this finding remains ill defined.
Scarpa
Maria Grazia
MG
Paediatric Surgery Unit, S. Bortolo Hospital, Vicenza, Italy.
Castagnetti
Marco
M
Berrettini
Alfredo
A
Rigamonti
Waifro
W
Musi
Luciano
L
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome; D014555:Urination Disorders / Q000453:epidemiology; D014563:Urodynamics; D013521:Urologic Surgical Procedures, Male / Q000379:methods*