Urinary Function After Snodgrass Repair of Distal Hypospadias: Comparison with the Mathieu Repair

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2010 Feb 20

PMID 20169443

Citations 12

Authors

Maria Grazia Scarpa

Marco Castagnetti

Alfredo Berrettini

Waifro Rigamonti

Luciano Musi

Affiliations

Soon will be listed here.

Abstract

Purpose: 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.

Patients And 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.

Citing Articles

Modified versus Classical Tubularised Incised Plate Urethroplasty in Hypospadias: A Comparative Study.

Abdullateef K, Elbarbary M, Kaddah S, Elezaby B, Ragab A, Mohamed W Afr J Paediatr Surg. 2024; 21(2):111-116.

PMID: 38546249 PMC: 11003566. DOI: 10.4103/ajps.ajps_107_22.

Urethral Plate Characteristics in Cases of Non-proximal Hypospadias May Not Be Associated With a Higher Risk of Complications When a Two-Stage Repair Is Applied.

Marcou M, Bobbe S, Wullich B, Hirsch-Koch K Front Pediatr. 2022; 10:900514.

PMID: 35874589 PMC: 9304744. DOI: 10.3389/fped.2022.900514.

Repair of distal hypospadias by construction of neourethra from augmented urethral plate with two lateral strips of glans skin and coverage with dartos flap followed by skin closure with preputial flap: single center series.

Wishahi M, Elkholy A, Badawy M Cent European J Urol. 2021; 73(4):526-533.

PMID: 33552580 PMC: 7848827. DOI: 10.5173/ceju.2020.0065.R4.

Chronological Changes In Uroflowmetry After Hypospadias Repair: An Observational Study.

Al Adl A, Omar R, Mohey A, El Mogy A, El Karamany T Res Rep Urol. 2019; 11:269-276.

PMID: 31696095 PMC: 6814353. DOI: 10.2147/RRU.S227601.

Role of uroflowmetry before and after hypospadias repair.

Piplani R, Aggarwal S, Ratan S Urol Ann. 2018; 10(1):52-58.

PMID: 29416276 PMC: 5791458. DOI: 10.4103/UA.UA_78_17.

References

Bleustein C, Esposito M, Soslow R, Felsen D, Poppas D . Mechanism of healing following the Snodgrass repair. J Urol. 2000; 165(1):277-9. DOI: 10.1097/00005392-200101000-00078. View

Toguri A, Uchida T, Bee D . Pediatric uroflow rate nomograms. J Urol. 1982; 127(4):727-31. DOI: 10.1016/s0022-5347(17)54018-5. View

Garibay J, Reid C, Gonzalez R . Functional evaluation of the results of hypospadias surgery with uroflowmetry. J Urol. 1995; 154(2 Pt 2):835-6. DOI: 10.1097/00005392-199508000-00137. View

Wolffenbuttel K, Wondergem N, Hoefnagels J, Dieleman G, Pel J, Passchier B . Abnormal urine flow in boys with distal hypospadias before and after correction. J Urol. 2006; 176(4 Pt 2):1733-6. DOI: 10.1016/S0022-5347(06)00614-8. View

Braga L, Pippi Salle J, Lorenzo A, Skeldon S, Dave S, Farhat W . Comparative analysis of tubularized incised plate versus onlay island flap urethroplasty for penoscrotal hypospadias. J Urol. 2007; 178(4 Pt 1):1451-6. DOI: 10.1016/j.juro.2007.05.170. View

Nguyen M, Snodgrass W . Tubularized incised plate hypospadias reoperation. J Urol. 2004; 171(6 Pt 1):2404-6. DOI: 10.1097/01.ju.0000125018.90605.a5. View

Emir L, Erol D . Mathieu urethroplasty as a salvage procedure: 20-year experience. J Urol. 2003; 169(6):2325-6; author reply 2326-7. DOI: 10.1097/01.ju.0000067386.48194.ee. View

Gurdal M, Tekin A, Kirecci S, Sengor F . Intermediate-term functional and cosmetic results of the Snodgrass procedure in distal and midpenile hypospadias. Pediatr Surg Int. 2004; 20(3):197-9. DOI: 10.1007/s00383-004-1146-2. View

Snodgrass W . Does tubularized incised plate hypospadias repair create neourethral strictures?. J Urol. 1999; 162(3 Pt 2):1159-61. DOI: 10.1016/S0022-5347(01)68110-2. View

10.

Horowitz M, Salzhauer E . The 'learning curve' in hypospadias surgery. BJU Int. 2006; 97(3):593-6. DOI: 10.1111/j.1464-410X.2006.06001.x. View

11.

Lopes J, Schned A, Ellsworth P, Cendron M . Histological analysis of urethral healing after tubularized incised plate urethroplasty. J Urol. 2001; 166(3):1014-7. View

12.

Borer J, Bauer S, Peters C, Diamond D, Atala A, Cilento Jr B . Tubularized incised plate urethroplasty: expanded use in primary and repeat surgery for hypospadias. J Urol. 2001; 165(2):581-5. DOI: 10.1097/00005392-200102000-00075. View

13.

Holmdahl G, Karstrom L, Abrahamsson K, Doroszkiewicz M, Sillen U . Hypospadias repair with tubularized incised plate. Is uroflowmetry necessary postoperatively?. J Pediatr Urol. 2008; 2(4):304-7. DOI: 10.1016/j.jpurol.2005.11.018. View

14.

Snodgrass W . Tubularized incised plate hypospadias repair: indications, technique, and complications. Urology. 1999; 54(1):6-11. DOI: 10.1016/s0090-4295(99)00144-2. View

15.

Kaya C, Kucuk E, Ilktac A, Ozturk M, Karaman M . Value of urinary flow patterns in the follow-up of children who underwent Snodgrass operation. Urol Int. 2007; 78(3):245-8. DOI: 10.1159/000099346. View

16.

Hammouda H, El-Ghoneimi A, Bagli D, McLorie G, Khoury A . Tubularized incised plate repair: functional outcome after intermediate followup. J Urol. 2002; 169(1):331-3; discussion 333. DOI: 10.1016/S0022-5347(05)64120-1. View

17.

Neveus T, von Gontard A, Hoebeke P, Hjalmas K, Bauer S, Bower W . The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children's Continence Society. J Urol. 2006; 176(1):314-24. DOI: 10.1016/S0022-5347(06)00305-3. View

18.

Marte A, Di Iorio G, De Pasquale M, Cotrufo A, Di Meglio D . Functional evaluation of tubularized-incised plate repair of midshaft-proximal hypospadias using uroflowmetry. BJU Int. 2001; 87(6):540-3. DOI: 10.1046/j.1464-410x.2001.00090.x. View

19.

Elbakry A . Further experience with the tubularized-incised urethral plate technique for hypospadias repair. BJU Int. 2002; 89(3):291-4. DOI: 10.1046/j.1464-4096.2001.01525.x. View

20.

Holland A, Smith G . Effect of the depth and width of the urethral plate on tubularized incised plate urethroplasty. J Urol. 2000; 164(2):489-91. View