[Midline urethral-plate incision followed by Mathieu urethroplasty for repair of distal hypospadias].

OBJECTIVE

To compare the effect of midline urethral-plate incision followed by Mathieu urethroplasty (MUPI-MU) with that of tubularized incised-plate (TIP) urethroplasty in the treatment of distal hypospadias.

METHODS

We retrospectively analyzed the clinical date on 72 cases of distal hypospadias treated in our hospital from August 2016 to January 2019, of which 21 (including 5 cases with a narrow urethral plate, small flat glans and shallow urethral groove) underwent MUPI-MU and the other 51 received TIP urethroplasty. We followed up the patients postoperatively and compared the shape and position of the urethral meatus and incidences of glanular dehiscence, fistula, stenosis and diverticulum between the two groups.

RESULTS

After surgery, the urethral meatus was found vertical, slit-like and in a normal anatomical position in 19 cases (90.5%) in the MUPI-MU and 46 cases (90.2%) in the TIP group, with no statistically significant difference in the shape of the urethral meatus between the two groups (P>0.05). The postoperative incidence of fistula was significantly lower in the MUPI-MU than in the TIP group (1 ［4.8%］ vs 15 ［29.4%］, P = 0.048), and so was that of meatal stenosis (0 vs 12 ［23.5%］, P = 0.037), but no statistically insignificant differences were observed between the MUPI-MU and TIP groups in the incidence of either glanular dehiscence (1 ［4.8%］ vs 2 ［9.8%］, P>0.05) or diverticulum (1 ［4.8%］ vs 6 ［11.8%］, P>0.05). No postoperative complications occurred in the 5 cases with a narrow urethral plate, small flat glans and shallow urethral groove.

CONCLUSIONS

MUPI-MU can achieve a normal-looking, vertical, slit-like urethral meatus with a reasonable urethral diameter and minimized incidence of complications, especially applicable to the distal hypospadias patients with a narrow urethral plate, small flat glans and shallow urethral groove.