Hybrid Mathieu Urethroplasty: A Simple Modification Outcomes

Distal hypospadias repair is one of the most frequent surgical interventions in the pediatric age group. Successful hypospadias repair should provide a functional penis and good cosmetic results. Mathieu urethroplasty is one of the most popular techniques used. The authors aimed at performing a modification that expanded the scope of indications and improved the final cosmetic results of classic Mathieu urethroplasty.

Forty-three patients with distal hypospadias were operated by hybrid Mathieu urethroplasty (HMU) during the period from March 2012 to December 2020. All cases had small size glans. Creation of the perimeatal-based flap was performed as Mathieu disrobed. This was followed by the development of glanular wings. The additional step was deep incision of the urethral plate. Then, urethroplasty was performed. The catheter was left in place for 1-3 days.

The mean age was 1.5 years, and the mean operative time was 67 minutes (60-75 minutes). The mean size of glans was 12 mm (10-15 mm). Fistula developed in three cases. No stricture or meatal regression developed. Infection with disruption of repair occurred in one case.

Hybrid Mathieu urethroplasty represents a reliable and successful solution for the cases of distal penile hypospadias with small glans and shallow urethral plate. It increases the scope of candidates of the Mathieu procedure, improves the final cosmetic results and has a reasonable rate of complications.