Evaluation of Snodgrass technique in the management of hypospadias in Heevi hospital

الملخص EN

Background and objectives Hypospadias (hi-poe-spay-dee-us) is a common congenital anomaly affecting the penis in which the opening of the urethra is on the underside of the penis, instead of the tip.

It may also cause a curvature of the penis (chordee).

Hypospadias cause a lot of functional and psychological problems to the patient.

The opening located anywhere along the length of the urethra.

Treating hypospadias is a challenging mission for the surgeons.

Hundreds of techniques were used but none of them was the standard method.

The aim of the study was to evaluate Snodgrass technique (tubularized incised plate TIP) in the management of distal and midshaft hypospadias of our patients comparing the results to the international figures.

Methods From June 2006 to September 2009 thirty two patients with coronal, subcoronal distal and midshaft hypospadias were operated on in Heevi hospital.

Cases with proximal hypospadias and those with severe chordee were excluded from the study.

Information gathered about the age of the patient, type of the defect, previous interventions or circumcision and operative procedure used.

We used the technique of Snodgrass repair with preputal flap.

The neo urethra stented with catheter for a period of 1-2 weeks post operatively.

Results were assessed with regards to the cosmetic appearance, urine stream and complications (dehiscence, fistula, stricture, meatal stenosis).

Results The total number of patients operated on using TIP technique was 32.

The age varied between 10 months and 5 years, four of them were circumcised and three had previously failed surgery.

Five had chordee.

The follow up period ranged from 4 months to three years.

The types of hypospadias were coronal (6 cases), subcoronal (12 cases), distal shaft (10 cases), and midshaft (4 cases).

The cosmetic outcome was satisfactory for all parents involved in this study.

Twenty-nine cases had straight stream.

Ten patients had meatal stenosis.

Two patients had micro fistula.

Conclusion Snodgrass technique for distal and midshaft hypospadias repair has good outcome and fewer complications.