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Hypospadias repair and glans augmentation using a modified Mathieu technique.
Behtash Ghazi Nezami1, Amir Hassan Mahboubi, Roozbeh Tanhaeivash
1Department of Pediatric Urology, Pediatric Urology Research Center, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Pediatric Surgery International
|November 17, 2009
Summary
A modified Mathieu technique (DF-Mathieu) offers a successful surgical option for hypospadias repair in children with small glans and shallow urethral grooves, showing improved outcomes compared to the TIP procedure.
Area of Science:
- Urology
- Pediatric Surgery
Background:
- Hypospadias repair in children with small glans and shallow urethral grooves presents surgical challenges.
- Existing techniques may have limitations in achieving optimal cosmetic and functional outcomes.
Purpose of the Study:
- To describe a modified Mathieu technique (DF-Mathieu) incorporating glans augmentation for hypospadias repair.
- To evaluate the efficacy and safety of the DF-Mathieu technique in pediatric patients with small glans and shallow urethral grooves.
Main Methods:
- A prospective study comparing the DF-Mathieu technique (33 patients) with the tubularized incised plate (TIP) procedure (21 patients).
- The DF-Mathieu technique utilizes a double-faced perimeatal-based skin flap for glans coverage and augmentation.
- Patients were followed up for a mean of 20 months.
Main Results:
- The DF-Mathieu group had a 97% success rate, with one urethral fistula.
- The TIP group had a 90.5% success rate, with one glans fistula and one meatal stenosis.
- All DF-Mathieu patients achieved a slit-like meatus with satisfactory cosmetic results.
Conclusions:
- The DF-Mathieu technique is a viable and effective option for hypospadias repair in patients with small glans and shallow urethral grooves.
- This modified technique reduces tension on glans wing sutures, potentially lowering the risk of neo-urethral breakdown compared to the TIP procedure.
