Компаративна студија за решавање на примарните антериорни хипоспадии по методите на Snodgrass и Mathieu

Abstract

Introduction: Hypospadia a congenital anomaly in which the urethral meatus is ectopically positioned on the ventral side of the penis. There are several classifications depending on the abnormal position of the urinary meatus.Three types of hypospadia are most frequent: anterior, penile and posterior.Hypospadia is result of incomplete tubularization or fusion of the urethral plate leading to an abnormal location of the meatus. The etiological cause for development of hypospadias lies in the disordered embryology of the penis due to disorders of hormone receptors, genetic disorders, enzyme disorders, influence of external environment and endocrine disorders. The incidence of hypospadias is reported to be approximately 1 in 200- 300 live-born male babies. Material and methods: A total of 300 patients operated on for anterior hypospadia at the University Clinic of Pediatric Surgery in Skopje were included in the study. Patients were divided in two groups, each one containing 150 children, who underwent surgery using the surgical techniques by Mathieu (Meatal-based flap technique) and Snodgrass (Tubularized incised plate urethroplasty). Results: The following parameters were assessed: duration of surgery, days of hospitalization, complications (urethral meatal stenosis, urethral diverticulum, urethral fistula, urethroplasty disruption). The results obtained were analyzed with numeric and qualitative statistical methods. Conclusion: The study has shown that Snodgrass surgical procedure known as Tubularized incised plate urethroplasty is superior and more acceptable in formation of anterior hypospadias than the Mathieu procedure . Cosmetic outcome and functionality of the penis meet all the criteria for anterior hypospadias repair using the Snodgrass procedure and it is a method of choice. However, in cases where there is no healthy urethral plate the surgical technique by Mathieu is recommended.