COMPARISON OF MATHIEU VS TUBULARIZED INCISED PLATE (SNODGRASS) TECHNIQUES OF URETHROPLASTY IN DISTAL PENILE HYPOSPADIAS

Abstract

Background: Hypospadias is a congenital abnormality characterized by opening of external urethral meatus on ventral aspect of
the penis with an overall incidence of 1:300. Different treatment modalities have been employed in the treatment of distal penile
hypospadias with varying degrees of success and complications. A number of studies have compared Mathieu and Snodgrass
Techniques but the existing evidence is doubtful owing to small sample size and great variation in their results. Objective: To
compare the outcome of Mathieu repair with that of tubularized incised Plate Urethroplasty (Snodgrass) in distal penile
hypospadias. Methodology: 90 patients meeting the inclusion and exclusion criteria's were selected and divided into two equal
groups randomly using lottery method. Group-A was treated by Mathieu technique and Group-B underwent Snodgrass repair.
Operative time was noted in minutes from the start of procedure till the end. Patients were followed post-operatively at 15th day, 1
Month and 2 Months and functional recovery and complications were evaluated. Results: The age of the patient ranged from 1 to
25 years in both groups with mean age of 6.67±5.74 years in Group-A and 6.65±6.06 years in Group-B (p=0.982). Snodgrass was
better in terms of mean operative time (67.37±8.85 minutes versus 87.86±8.22; p=0.00) as compared to Mathieu technique. The
functional outcome in terms of meatal location at tip was better in Snodgrass (93.7% versus 80.2%; p=0.003) with a lower fistula
rate (5.4% versus 21.6%; p=0.00) as compared to Mathieu technique. Conclusion: Tubularized Incised Plate Urethroplasty
(Snodgrass) is better than Mathieu technique for the treatment of distal penile hypospadias in terms of operative time, success and complication rate.