Comparativa en hipospadia distal: mejoras al comparar?
J Pediatr Surg. 2018 Aug;53(8):1461-1463. doi: 10.1016/j.jpedsurg.2018.03.019. Epub 2018 Mar 21.
Does grafted tubularized incided plate improve the outcome after repair of primary distal hypospadias: A prospective randomized study?
Helmy TE1, Ghanem W2, Orban H2, Omar H 2, El-Kenawy M2, Hafez AT2, Dawaba M2.
1. Urology and Nephrology Center, Mansoura University, Egypt. Electronic address: firstname.lastname@example.org.
2. Urology and Nephrology Center, Mansoura University, Egypt.
To detect whether grafting the incised plate during Snodgrass repair would improve outcome.
MATERIALS AND METHODS:
Sixty patients with primary distal hypospadias were included. Patients were equally randomized using closed envelop method to either Snodgrass or grafted tubularized incised plate repair (GTIP). All operations were performed by a single surgeon. All intaroperative data were recorded. All patients were followed up for 1 year. Success was defined as slit shaped meatus at the tip of the glans with no stenosis, fistula or diverticulum.
All 60 patients were evaluated at 1 year of follow-up. Mean age at surgery was 40±15months. Both groups were comparable as regard to patients’ age, meatus location, length and width and depth of urethral plate and glans width. Success was documented in 29/30 patients (96.7%) in the Snodgrass group. The only complication was meatal stenosis in one patient, whereas success was documented in 28/30 patients (93.3%) in the GTIP group. The two failures were secondary to partial glans dehiscence. Success rate was not statistically different. Flow rate data at 1 year showed insignificant difference between both groups as regards Q-max and voiding time. The only statistically significant difference between both groups was a longer operative time 106±12min in the GTIP group compared to only 77±9 for the Snodgrass group (p = 0.005).
Snodgrass and GTIP techniques for primary distal hypospadias repair have similar outcome. With a significantly shorter operative time, Snodgrass repair remains the first choice for primary distal hypospadias repair.