Surgery to repair hypospadias has a history of more than 150 years. To date more than 300 surgical procedures with accompanying variations have been proposed for the repair of hypospadias. Such repair should be simple, applicable to most of the cases, complete in a single stage and resulting in an acceptable cosmetic appearance with a low complication rate.
The incidence of hypospadias isapproximately 1 in every 300 male births. In approximately 65% of cases the hypospadiac meatus is located in the glandular, subcoronal or distal shaft position with minimal chordee.
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The purpose of this study is to evaluate the results and complications after ombined use of Mathieu and incised plate technique for management of primary distal hypospadias.
This study wass prospective and was conducted at the period from april 2014 to August 2015 at the urology department, Banha university hospital.
thirty patients presented with distal hypospadias (coronal - subcoronal – distal penile) participated in our study after informed written consent from their parents.
Points of assessment included; the incidence of infection, fistula formation, complete disruption of the repair, edema, the glans shape and meatal site, shape and caliber.
In 21 cases among study group postoperative neomeatus site was at the tip of the glans penis, in 9 cases postoperative neomeatus site was distal glanular. also 1 case with postoperative hematoma which was controlled by evacuation and compression and antibleeding measures, this case complicated by glans dehiscense which was controlled by surgical correction after 3 monthes, this case was not circumcised and corrected by duckket repair. also 1 case postoperative meatal stenosis whish was controlled by regular dilatation for 1 month,1 case among study group complicated by postoperative infection, this case needed regular dressing and parentral antibiotics, it was complicated urethrocuteanus fistula whish was corrected surgically after 3 monthes.
So adding the TIP principles to the standard Mathieu procedureappear to be a helpful measure to reshape the urethral meatus andgive a better functional and cosmetic result and decrease the incidenceof meatal stenosis and fistula formation.
The only drawback of combining the two techniques in our studywas the need for more analgesia to relieve pain; however the advantagesgained are more when considering this drawback.
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