title: Comparative study of Mirs(') (Mushtaq and Shabir) technique of prepuce preserving minimally invasive urethroplasty with Snodgrass urethroplasty for repair of distal hypospadias without chordee…A prospective study.
abstract: BACKGROUND
  There is no single, universally applicable technique for hypospadias repair and numerous techniques have been practised from time to time. We compare the results of our new technique (Mirs' technique also called Mush & Shab's technique) to Snodgross urethroplasty. Mirs' technique is a modified version of Thiersch-Duplay urethroplasty.
  
  
  METHODS
  This prospective comparative study was carried out in a tertiary care hospital of Northern India over a period of 3 years from March 2010 to March 2013 and included 120 patients of anterior (distal penile, subcoronal, coronal and glanular) hypospadias without chordee. They underwent either Mirs' technique (group 1 n = 60) or Snodgrass technique (group 2 n = 60). Follow-up was at 1-week, 1-month, 3 months and 6 months.
  
  
  RESULTS
  The mean operative time was 55 min (range: 43-70 min) in group 1 and 71.9 min (range: 60-81 min) in group 2 (P < 0.001). Urethrocutaneous fistula developed in two and four patients in group 1 and 2, respectively. Fistula closure was done at least 3 months postoperatively, and there was no significant difference in success rate between the two groups. Three cases of glanular dehiscence were detected (one in group 1 and two in group 2); the patient from group 1 had a successful repair using the already preserved prepuce.
  
  
  CONCLUSIONS
  Mirs' modification of Thiersch-Duplay technique for distal hypospadias is a time saving procedure with a lower overall complication rate. Valuable local tissue is preserved to deal with any complication that may occur. Analgesic requirement was significantly lower in this minimally traumatic technique. As it is less time consuming, simple and easy to learn with a short learning curve, this technique deserves application in cases of distal hypospadias.
authors.affiliation: Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors.forename: Mushtaq
authors.initials: M
authors.lastname: Mir
authors.affiliation: Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors.forename: Shabir Ahmad
authors.initials: SA
authors.lastname: Mir
authors.affiliation: Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors.forename: Muddassir
authors.initials: M
authors.lastname: Shahdhar
authors.affiliation: Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors.forename: Mumtazdin
authors.initials: M
authors.lastname: Wani
authors.affiliation: University of Kashmir, Srinagar, Jammu and Kashmir, India.
authors.forename: Hakim Adil
authors.initials: HA
authors.lastname: Moheen
authors.affiliation: Department of Radiodiagonosis, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors.forename: Jahangeer Ahmad
authors.initials: JA
authors.lastname: Bhat
keywords: Mirs’ technique; Snodgrass technique; prepuce preserving