Snodgrass procedure for primary hypospadias repair.

ABSTRACT

BACKGROUND: In this study, the authors' experience in adaptation of the Snodgrass technique for primary hypospadias repair, with an alternative way to create a barrier layer of dartos flap for neourethral covering, is presented. METHODS: Between March 2000 and January 2001, Snodgrass urethroplasty was consecutively done on 24 boys aged between 14 months and 9 years (median 3 years). The position of the meatus was coronal in one boy, at the distal shaft in two, at mid-shaft in eight, at the proximal shaft in five, penoscrotal in four, scrotal in three and perineal in one. Dorsal plication was carried out in nine patients (37.5%) to correct residual ventral curvature after penile degloving. Postoperatively the neourethra was stented for 10-12 days and suprapubic diversion was used for 12-14 days. RESULTS: Postoperative follow up ranged from 4 to 14 months (median 8 months). All patients undergoing Snodgrass repair obtained a neourethra with a slit-like meatus at the tip of the glans. A small urethrocutaneous fistula occurred in one patient with mid-shaft and two with proximal-shaft hypospadias (an overall fistula rate of 12.5%). Urethral stricture had not been encountered at the time of this report. One patient developed mild meatal stenosis and was successfully managed by simple dilatation. CONCLUSIONS: The results indicate that Snodgrass urethroplasty provides satisfactory cosmetic and functional results and is versatile in repairing almost all types of hypospadias.