Hybrid Mathieu Urethroplasty: A Simple Modification Outcomes

Area of Science:

• Pediatric Urology
• Surgical Techniques

Background:

• Distal hypospadias repair is a common pediatric surgical procedure.
• Mathieu urethroplasty is a popular technique for hypospadias repair.
• Modifications aim to broaden indications and enhance cosmetic results.

Purpose of the Study:

• To evaluate the efficacy of a modified Mathieu urethroplasty (hybrid Mathieu urethroplasty - HMU) for distal hypospadias.
• To assess HMU's suitability for patients with small glans and shallow urethral plates.
• To compare cosmetic and functional outcomes with classic Mathieu urethroplasty.

Main Methods:

• A hybrid Mathieu urethroplasty (HMU) was performed on 43 pediatric patients with distal hypospadias and small glans.
• The technique involved a perimeatal-based flap, glanular wing development, and deep urethral plate incision.
• Catheters were used for 1-3 days post-operation.

Main Results:

• The mean patient age was 1.5 years, with a mean operative time of 67 minutes.
• Mean glans size was 12 mm.
• Complications included fistula in 3 cases and infection with repair disruption in 1 case; no stricture or meatal regression occurred.

Conclusions:

• Hybrid Mathieu urethroplasty is a reliable and successful technique for distal penile hypospadias, particularly in cases with small glans and shallow urethral plates.
• HMU expands the applicability of the Mathieu procedure and yields improved cosmetic results.
• The complication rate associated with HMU is reasonable.