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[Anterior hypospadias: Duplay or Mathieu?]
1Service de Chirurgie Pédiatrique, CHU Côte de Nacre, Caen, France. ravasse-p@chu-caen.fr
Summary
Both Mathieu and Duplay urethroplasties offer comparable urethral outcomes for anterior hypospadias repair. Duplay urethroplasty may provide a more satisfactory meatal appearance, with the Snodgrass modification enhancing its applicability.
Area of Science:
- Pediatric Urology
- Surgical Reconstruction
Background:
- The Mathieu urethroplasty is a standard surgical treatment for anterior hypospadias.
- The Snodgrass modification of the Duplay urethroplasty allows for tubularization of narrow urethral plates, expanding surgical indications.
Purpose of the Study:
- To compare the outcomes of Mathieu urethroplasty and Duplay urethroplasty in treating anterior hypospadias.
Main Methods:
- A comparative study involving 50 Mathieu urethroplasties and 50 Duplay urethroplasties performed by a single surgeon.
- Standardized surgical techniques including inverted running sutures and Foley catheter drainage were employed.
- The Snodgrass modification (longitudinal urethral plate incision) was utilized in 17 Duplay cases; foreskin reconstruction was performed in 41 cases.
Main Results:
- Follow-up ranged from 6 months to 4 years.
- Both groups had a 6% reoperation rate due to urethral complications (fistula, meatal stricture, dehiscence).
Conclusions:
- Mathieu and Duplay urethroplasties yield equivalent urethral results.
- Duplay urethroplasty appears to offer superior cosmetic outcomes regarding the urinary meatus.
- The Snodgrass modification broadens the indications for Duplay urethroplasty, and flap coverage can mitigate fistula rates.