Comparative Study of Modifying Meatal Advancement Glandular with Release Chordi versus Snodgrass Surgical Methods Regarding the Repair of Distal Hypospadias

Askarpour, Shahnam; Peyvasteh, Mehran; Mohamadi, Armin; Khoshkhabar, Mahmoud

doi:10.52547/wjps.10.3.73

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…The incidence was higher in the TIP urethroplasty group (10 cases) than in the modi ed MAGPI group (four cases). This nding was not observed in the present study as the incidence of stula was the same in both groups; this may be due to the low number of patients included in our study [13].…”

Section: Discussioncontrasting

confidence: 73%

Modified meatal advancement and glanuloplasty versus tubularized incised plate urethroplasty for distal hypospadias repair: A prospective randomized study

Fathi

Gammal

Ghoneimy

et al. 2022

Preprint

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Background: About one in every 300 male births has hypospadias, and the meatus is located distally in approximately 65% of cases. Hypospadias is defined as a maldevelopment of the urethral fold and ventral foreskin, with or without the penile curvature. Any recent classification must include the urethral meatus site, prepuce (complete or incomplete), urethral plate width, glans (flat, cleft, or incomplete cleft), and other associated anomalies if present. Methods: This prospective randomized comparative study was conducted at Al-Azhar University Hospitals from April 2022 to October 2022. Fifty-seven cases with different types of hypospadias were assessed for illegibility. Among them, seven cases were excluded due to the presence of chordee (n = 3), proximal variant (n = 2), and recurrent cases of hypospadias (n = 2). Fifty cases were randomly divided into two groups according to a 1:1 ratio (computer-generated randomization). Twenty-five cases were subjected to modified meatal advancement and glanuloplasty (MAGPI), and the rest were subjected to tubularized incised plate (TIP) urethroplasty. Results: The mean age of all studied cases was 4.2 years. Approximately 52% had coronal or subcoronal meatus, whereas 48% had glandular meatus. Both groups were matched according to age and meatus location (p > 0.05). No statistically significant difference was observed between the two groups in terms of time of operation, postoperative pain, and postoperative hospital stay. In addition, late complications (meatal stenosis, meatal retraction, fistula, and breakdown of the repair) did not differ significantly between both groups. Conclusions: Modified MAGPI and TIP urethroplasty have comparable short-term outcomes; however, TIP urethroplasty has a lower incidence of postoperative complications. Modified MAGPI is preferred in certain conditions, especially in circumcised child or those with a narrow urethral plate. Trial registration: The study protocol was approved by the Pan African Clinical Trials Registry (number for the registry is: PACTR202211757905870) at (29/11/2022). All procedures were performed in accordance with the Helsinki Declaration.

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Section: Discussioncontrasting

confidence: 73%

Modified meatal advancement and glanuloplasty versus tubularized incised plate urethroplasty for distal hypospadias repair: A prospective randomized study

Fathi

Gammal

Ghoneimy

et al. 2022

Preprint

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“…Considering the fact that MEMO and similar techniques are characterized by preserving the integrity of the native meatus and ureteral plate without the need for incision as in the Snodgrass technique, a lower incidence of complications (mainly urethral strictures and fistulas) can be expected. A study by Askarpour et al, compared the modified MAGPI with the Snodgrass technique and found a statistically significantly higher incidence of urethrocutaneous fistulas in patients operated on using the Snodgrass technique [11]. Seibold et al, re-examined 99 patients five years after surgery, none of whom had a stenosis, and only 1 patient developed a fistula postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, the technique of Meatal Mobilization with Glanuloplasty Inclusive (MMGPI) has emerged as a modification of MAGPI (Meatal Advancement and Glanuloplasty Inclusive) with the aim of further improving surgical outcomes in the repair of distal hypospadias. This technique requires the careful assessment of penile anatomy, dorsal foreskin, and urethral plate mobility to determine its feasibility [1,2,7,11].…”

Section: Introductionmentioning

confidence: 99%

Safety and Effectiveness of Meatal Mobilization (MEMO) Technique for Glandular, Coronal, and Subcoronal Hypospadias Repair in Children: A 5-Year Single-Center Study with 105 Hypospadias

Pogorelić,

Milovac,

Čohadžić

et al. 2024

Biomedicines

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Background: This study aims to compare outcomes of treatment, in terms of early and late complications, between the Snodgrass and meatal mobilization (MEMO) techniques in children operated on because of distal hypospadias. Methods: The medical records of 127 children who underwent glandular, coronal, or subcoronal hypospadias repair between 1 January 2019 and 31 December 2023 were retrospectively reviewed. A total of 105 children met the inclusion criteria and were included in further analysis. The inclusion criteria were pediatric patients who underwent glandular, coronal, or subcoronal hypospadias repair using MEMO (n = 49) or the Snodgrass technique (n = 56) as a comparative group. The primary outcome of this study was the incidence of early and late complications with two different surgical techniques. Secondary outcomes were the duration of surgery, the length of hospital stay, the number of readmissions or unplanned returns to the operating room, and repeat surgeries between groups. Results: The median age of all patients was 17 (interquartile range, IQR 13, 29) months, with a median follow-up of 26 (IQR 17, 34) months. Regarding the type of hypospadias, the majority of patients in both groups were categorized as coronal and subroronal hypospadias. Regarding the incidence of postoperative complications, a significantly lower incidence of postoperative complications was found in the MEMO group compared to the Snodgrass group (n = 4; 8.2% vs. n = 14; 25%; p = 0.037). An urethrocutaneous fistula was the most common complication in the Snodgrass group (n = 8; 14.3%), while in the MEMO group, only one patient (2%) developed a fistula (p = 0.034). The incidence of meatal stenosis (p = 0.621) and wound infections (p > 0.999) was low in both groups. No further complications were recorded during the follow-up period. Duration of surgery (41 min (IQR 38, 47) vs. 51 min (IQR 45.5, 61); p < 0.001), duration of hospitalization (1 day (IQR 1, 2) vs. 3 days (IQR 2, 6); p < 0.001), and time to catheter removal (3 days (IQR 2.5, 5) vs. 6 days (IQR 6, 8); p < 0.001) were significantly lower in patients operated on with MEMO compared to the Snodgrass technique. Only one case of readmission due to severe wound infection which led to suturing line dehiscence was recorded in the Snodgrass group. The incidence of redo surgery was significantly lower in the MEMO group than in the Snodgrass group (n = 3; 6.1% vs. n = 11; 19.6%; p = 0.048). Conclusions: MEMO is a safe and effective technique that can be used for the treatment of distal hypospadias. It showed excellent outcomes, cosmetic results, and a low incidence of complications as well as a significantly shorter duration of surgery compared to the Snodgrass technique.

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“…Middle (30%) which includes the distal penile, mid-shaft and proximal penile regions, and the posterior type is 20% of cases including penoscrotal, scrotal and perineal. 5 , 6 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Complications and Effectiveness of Snodgraft Method on the Treatment of Distal Hypospadias or Midshaft

Peyvasteh

Askarpour

Mohamadi

et al. 2022

WJPS

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Objective: Hypospadias is one of the most common diseases of the male reproductive system. Considering the different treatment techniques for this anomaly and important complications such as fistula, meatal/neourethral stenosis, an attempt is made to use a method that has the best result and the least complication for treatment. The aim of this study was to evaluate the snodgraft method in repairing distal or midshaft hypospadias in terms of complications, beauty and effectiveness. Methods: In this retrospective study, conducted Oct 2018 to Oct 2020, 60 boys with distal hypospadias or midshaft who underwent the methods of Snodgraft in Imam Khomeini and Abuzar Hospitals of Ahvaz, southern Iran were enrolled. All patients were followed up and examined for postoperative complications after surgery with intervals of 1 week, 2 weeks, monthly to 6 months and then annually. Results: The mean age of patients was 30.1±11.3 months. No surgical diverticulitis or meatal stenosis was seen after surgery. Urethrocutaneous fistula was seen in 4 patients at initial follow-up, of these 4 patients, 1 spontaneous improvement was seen after 6 months. Urinary status was normal in all patients. Bleeding, hematoma and meatus stenosis were not observed in patients. In all patients, the appearance of meatus was very good and similar to normal people. Conclusion: The snodgraft surgery method in repairing hypospadias is a very simple, appropriate method and with a good appearance of Glans and Meatus, and the complications of this technique are few and acceptable. To confirm our findings, prospective studies with larger sample size of patients are needed.

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Comparative Study of Modifying Meatal Advancement Glandular with Release Chordi versus Snodgrass Surgical Methods Regarding the Repair of Distal Hypospadias

Cited by 3 publications

References 16 publications

Modified meatal advancement and glanuloplasty versus tubularized incised plate urethroplasty for distal hypospadias repair: A prospective randomized study

Modified meatal advancement and glanuloplasty versus tubularized incised plate urethroplasty for distal hypospadias repair: A prospective randomized study

Safety and Effectiveness of Meatal Mobilization (MEMO) Technique for Glandular, Coronal, and Subcoronal Hypospadias Repair in Children: A 5-Year Single-Center Study with 105 Hypospadias

Evaluation of Complications and Effectiveness of Snodgraft Method on the Treatment of Distal Hypospadias or Midshaft

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