Application of Urethral-Plate Longitudinal Incision in Mathieu Repair for Hypospadias Reoperation

This study aimed to compare the efficacy and complication rates of urethral-plate longitudinal incision combined with Mathieu repair versus tubularized incised plate (TIP) in the reoperation of hypospadias.

This study retrospectively analyzed 46 patients with subcoronal urethral fistula and glans dehiscence after hypospadias operation in our hospital from February 2021 to March 2023. It has been 6-56 months since the initial operation. For the selected patients with subcoronal fistula, the tissues from the fistula to the urethral orifice were cut in the membranous or skin bridge shape. Meanwhile, all patients were divided into two groups, including group A and group B. Group A (n = 19) received the urethral-plate longitudinal incision combined with Mathieu repair. Group B (n = 27) adopted conventional TIP repair. The complication rate and urethral orifice shape were compared between the two groups.

In terms of postoperative follow-up, there were three cases with complications in group A and 12 in group B, and the difference was statistically significant (p = 0.041). With regard to urethral orifice, no case in group A and seven cases in group B had urethral orifice, and the difference was statistically significant (p = 0.036). Except for glans dehiscence, all cases with urethral orifice in both groups had a fissured appearance.

As an effective approach to repair glans dehiscence and subcoronal fistula after hypospadias operation, urethral-plate longitudinal incision combined with Mathieu helps to further expand the urethral orifice and form a reasonable vertical fissured urethral orifice. Institutional Reviewer Board: IRB:EYLL-2023-006.