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Comparison between Single and Double Dartos Layers Snodgrass Technique for Hypospadius Repair : Results of Our Experience

Author: Ali Hadi Sabhan
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 330 -336
Publisher: Babylon University جامعة بابل

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Abstract

To compare our results with single versus double dartous layers Snodgrass technique for hypospadius repair, a comparative study was done and the results were compared in term of : the overall success and complications rates, percentage of each complication (urethrocutaneous fistula, meatal stenosis, urethral diverticulum and glandular or complete neourethradehiscence) with final cosmetic appearance and straightening of urinary stream.The study was extended from January 2013 to June 2015; including a randomly selected fourty three children with median age of 29 months (range from 12 to 66 months) with a primary hypospadias. Patients were divided into 2 groups: Group 1 include 21 patients that were selected to be operated by a single layer TIP technique.Group 2 include 22 patients that were selected to be operated by a double layer TIP technique.All patients under went Snodgrass technique urethroplasty in the surgical theater of Al-Diwaniya teaching general hospital under general anesthesia.The results shows a higher overall success rate and cosmetic appearance with lower complications for patients in group 2in comparison to those in group 1with no statistically significant difference. The neourethral covering in TIP hypospadias repair(Snodgrass technique) with double-dartos flap yield a better cosmetic and functional results in comparison to single dartos flap cover in terms of increasing success rate and minimizing complications specially in decreasing the rate of urethrocutaneous fistula formation which is the most common complication following this type of surgery.


Article
SNODGRASS URETHROPLASTY FOR MID AND DISTAL PENILE HYPOSPADIAS

Author: Ahmed Z. Zain احمد ازبار زين
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2017 Volume: 15 Issue: 3 Pages: 283-287
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Hypospadias describes a urethral opening proximal to the normal position at the glandular tip (anywhere on the ventral surface) and it is considered the most common penile anomaly. There are many surgical modalities for reconstruction but with different success. The goal of modern hypospadias repair is to achieve functionally as well as cosmetically normal looking glans, meatus and phallus. Snodgrass urethroplasty was introduced in 1974 with more reliable creation of a normal appearing meatus.Objective:To see the short-term results of tubularized incised plate urethroplasty as described by Snodgrass in mid and distal penile hypospadias.Methods:This is a prospective study for evaluation of fifty male children with age ranged from one to ten years with penile hypospadias (distal and mid shaft) were included in this study over a period from January 2008 to January 2016 in our pediatric surgical center.Results:The majority were between 2-4 years. Meatal stenosis (12%) and urethrocutaneous fistula (6%) were the most common complications encountered in this study. Inguinal hernia (8%) and undescended testis (10%) were the most common associated congenital anomalies with hypospadias.Conclusion:Snodgrass urethroplasty is simple, single stage operation in the management of mid and distal penile hypospadias with good cosmetic and functional results.Keywords:Hypospadias, Snodgrass technique, meatal stenosis, urethrocutaneous fistula. Citation:Zain AZ. Snodgrass urethroplasty for mid and distal penile hypospadias. Iraqi JMS. 2017; Vol. 15(3): 283-287. doi: 10.22578/IJMS.15.3.10

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