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Reoperative Snodgrass procedure.

S S Yang¹, S C Chen, C H Hsieh

¹Department of Urology, National Taiwan University Hospital and En Chu Kong Hospital, College of Medicine, National Taiwan University and Taipei Medical University, Taipei, Taiwan.

The Journal of Urology

|November 7, 2001

Summary

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The reoperative Snodgrass procedure is effective for complex hypospadias repair, particularly in patients without prior urethral plate alteration or fistulas. This method offers a viable solution for failed hypospadias surgeries, improving outcomes.

Area of Science:

Urology
Pediatric Surgery
Reconstructive Surgery

Background:

Hypospadias repair failures necessitate reoperative strategies.
Complex hypospadias cases present significant reconstructive challenges.

Purpose of the Study:

To evaluate the efficacy of a reoperative Snodgrass procedure for complex hypospadias.
To identify factors influencing outcomes in reoperative hypospadias surgery.

Main Methods:

25 patients with failed hypospadias repairs underwent a reoperative Snodgrass procedure.
Patients were categorized based on urethral plate status and preoperative fistulas (Group A: unaltered plate, no fistula; Group B: altered plate or fistula).
Outcomes including fistula, meatal stenosis, and stricture rates were assessed.

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Main Results:

The overall postoperative fistula rate was 28%, significantly lower in Group A (0%) compared to Group B (41.2%).
Surgically altered urethral plates and preoperative fistulas independently predicted higher fistula rates.
The postoperative meatal stenosis rate was 52%, with no significant difference between groups.

Conclusions:

The Snodgrass procedure is a viable option for reoperative hypospadias repair.
Outcomes are significantly better in patients with surgically unaltered urethral plates and no preoperative fistulas.