Comparison of snodgrass and mathieu surgical techniques in anterior distal shaft hypospadias repair

To compare the outcomes of Mathieu and Snodgrass techniques in the repair of anterior distal shaft hypospadias.

From 2001 to 2003, 33 patients with the mean age of 7.06 +/- 3.44 (range 2 to 12) years suffering from anterior distal shaft hypospadias, were assessed. Inclusion criteria were anterior distal shaft hypospadias, and exclusion criteria were association with chordee, circumcision, and surgical repair history. Fifteen patients underwent surgical repair using Snodgrass technique and 18 patients, using Mathieu technique. Surgeries were performed by one single surgeon, acquainted with both techniques. Patients were examined 1 week, 1 month, and 6 months after discharge. Data including duration of the surgery, stenting time, duration of hospitalization, and any kind of complications such as break down, meatal stenosis, and fistula formation were collected. Also, success rate was calculated for every single patient and accordingly, the two groups were compared.

Mean operative time, stenting duration, and hospital stay were 94 +/- 26.06 minutes, 5.06 +/- 1.31 days, and 3.93 +/- 1.86 days in Mathieu group and 106.11 +/- 23.04 minutes, 5.11 +/- 1.56 days, and 4.55 +/- 1.29 days in Snodgrass group, respectively (P >0.05). The rate of break down, meatal stenosis, and fistula formation were 0%, 0%, and 5.55% in Mathieu group and 0%, 6.66%, and 13.32% in Snodgrass group, respectively (P >0.05). Success rate was 80.02% in Snodgrass group and 94.45% in Mathieu group (P >0.05).

In spite of some reports about preference for Snodgrass technique, we concluded that these techniques are as acceptable and as effective as each other for hypospodias repairing, regardless of cosmetic outcomes; however, we need further studies and larger sample sizes to determine which the superior technique is.