Y-V meatoplasty: a simple novel technique to correct meatal stenosis.

BACKGROUND

Meatal stenosis is a common complication following hypospadias repair. Dilatation or meatotomy is usually not effective and may result in recurrence of symptoms.

AIM: To report our experience with Y-V meatoplasty, a simple novel technique to correct postoperative meatal stenosis after hypospadias surgery with up to 8 years of follow-up.

METHODS

A small inverted V skin flap is elevated with the angle at the tip of the meatus. Each limb is 3 to 5 mm long. A wedge of the narrow meatus underneath the flap is excised, creating a wide meatus. The tip of the inverted V is advanced distally and sutured to the angle inside the wide new meatus. The aim is to interrupt the ring suture line by introducing the V skin flap into the ring. This minimizes the chances of further ring contraction. The technique was used in 57 patients with symptomatic postoperative meatal stenosis from 2017 to 2024. The median age was 53 months (range, 17 months-44 years). Median follow-up was 4 years (range, 3 months-8 years).

OUTCOMES: The Y-V technique helped to relieve the obstructive symptoms in the majority of patients (55 patients).

RESULTS

Fifty-two patients recovered well without further symptoms or problems. Three children complained of mild dysuria after surgery that disappeared within a month after surgery without additional intervention. Two patients (3.5%) early in the study required further surgery due to inadequate excision of the stenotic ring. There were no cases of postoperative urinary tract infections.

CLINICAL IMPLICATIONS: The Y-V technique may be used to help any patient with ring meatal stenosis.

STRENGTHS AND LIMITATIONS: This study describes a novel meatoplasty variant in a rather large patient collective with long follow-up to 8 years and in some patients without any discomforts. However, it is a single-center retrospective study, and 6 patients did not maintain follow-up more than 1 year.

CONCLUSION

Y-V meatoplasty represents a simple effective technique to successfully correct postoperative ring meatal stenosis with a low complication rate of 3.5%.