Fig 2
Source publication
Background:
Hypospadias is one of the most common congenital anomalies of the external genitalia of boys. No single technique can be recommended for the repair of hypospadias in its various forms. We aimed to compare modify meatal advancement glandular with release chordi versus Snodgrass surgical methods in the repair of distal hypospadias.
Meth...
Citations
... The incidence was higher in the TIP urethroplasty group (10 cases) than in the modi ed MAGPI group (four cases). This nding was not observed in the present study as the incidence of stula was the same in both groups; this may be due to the low number of patients included in our study [13]. ...
Background
About one in every 300 male births has hypospadias, and the meatus is located distally in approximately 65% of cases. Hypospadias is defined as a maldevelopment of the urethral fold and ventral foreskin, with or without the penile curvature. Any recent classification must include the urethral meatus site, prepuce (complete or incomplete), urethral plate width, glans (flat, cleft, or incomplete cleft), and other associated anomalies if present.
Methods
This prospective randomized comparative study was conducted at Al-Azhar University Hospitals from April 2022 to October 2022. Fifty-seven cases with different types of hypospadias were assessed for illegibility. Among them, seven cases were excluded due to the presence of chordee (n = 3), proximal variant (n = 2), and recurrent cases of hypospadias (n = 2). Fifty cases were randomly divided into two groups according to a 1:1 ratio (computer-generated randomization). Twenty-five cases were subjected to modified meatal advancement and glanuloplasty (MAGPI), and the rest were subjected to tubularized incised plate (TIP) urethroplasty.
Results
The mean age of all studied cases was 4.2 years. Approximately 52% had coronal or subcoronal meatus, whereas 48% had glandular meatus. Both groups were matched according to age and meatus location (p > 0.05). No statistically significant difference was observed between the two groups in terms of time of operation, postoperative pain, and postoperative hospital stay. In addition, late complications (meatal stenosis, meatal retraction, fistula, and breakdown of the repair) did not differ significantly between both groups.
Conclusions
Modified MAGPI and TIP urethroplasty have comparable short-term outcomes; however, TIP urethroplasty has a lower incidence of postoperative complications. Modified MAGPI is preferred in certain conditions, especially in circumcised child or those with a narrow urethral plate.
Trial registration
The study protocol was approved by the Pan African Clinical Trials Registry (number for the registry is: PACTR202211757905870) at (29/11/2022). All procedures were performed in accordance with the Helsinki Declaration.
Hundreds of papers are written about hypospadias every year referring to all aspects of the pathology, being one of the most common congenital malformations. The present study conducted a scoping review of articles published in 2021 to present the main issues and summarize current perspectives and achievements in the field. It searched for the keyword 'hypospadias' in the three most popular databases (PubMed, Scopus and Web of Science). After the analysis of the publications, they were categorized into different domains. The present review was performed respecting the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA ScR) guidelines. A total of 284 articles were included. These were published in 142 different journals. The most accessed was the Journal of Paediatric Urology with 54 articles. The main identified domains were related to surgical techniques, postoperative care, complications, anesthesia, anatomical factors, genetics, environmental factors, endocrinology, associated malformations, questionnaires and recommendations, management, biological materials, animal models, retrospective studies of centers, social media, bibliometrics, small gestational age, neoplasm, or fertility. Promising modifications of existing surgical techniques were presented with improved outcomes for both the proximal and distal types of hypospadias. Relevant anatomical and etiological, and also genetic factors were clarified. Aspects of the peri- and postoperative management referring to the antibiotherapy, analgesia, dressing techniques, and the future use of novel bioengineering agents to prevent, reduce or treat the occurring complications were discussed.
Objective:
Hypospadias is one of the most common diseases of the male reproductive system. Considering the different treatment techniques for this anomaly and important complications such as fistula, meatal/neourethral stenosis, an attempt is made to use a method that has the best result and the least complication for treatment. The aim of this study was to evaluate the snodgraft method in repairing distal or midshaft hypospadias in terms of complications, beauty and effectiveness.
Methods:
In this retrospective study, conducted Oct 2018 to Oct 2020, 60 boys with distal hypospadias or midshaft who underwent the methods of Snodgraft in Imam Khomeini and Abuzar Hospitals of Ahvaz, southern Iran were enrolled. All patients were followed up and examined for postoperative complications after surgery with intervals of 1 week, 2 weeks, monthly to 6 months and then annually.
Results:
The mean age of patients was 30.1±11.3 months. No surgical diverticulitis or meatal stenosis was seen after surgery. Urethrocutaneous fistula was seen in 4 patients at initial follow-up, of these 4 patients, 1 spontaneous improvement was seen after 6 months. Urinary status was normal in all patients. Bleeding, hematoma and meatus stenosis were not observed in patients. In all patients, the appearance of meatus was very good and similar to normal people.
Conclusion:
The snodgraft surgery method in repairing hypospadias is a very simple, appropriate method and with a good appearance of Glans and Meatus, and the complications of this technique are few and acceptable. To confirm our findings, prospective studies with larger sample size of patients are needed.
