COMPLICATIONS OF SNODGRASS URETHROPLASTY IN PATIENTS WITH DISTAL AND MID PENILE HYPOSPADIAS

M AAMIR; I ULLAH

doi:10.54112/pjicm.v5i01.60

Authors

M AAMIR Department of Burns and Plastic Surgery Centre, Hayatabad Medical Complex, Peshawar, Pakistan
I ULLAH Department of Burns and Plastic Surgery Centre, Hayatabad Medical Complex, Peshawar, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i01.60

Keywords:

Snodgrass Urethroplasty, Complications, Urethrocutaneous Fistula, Meatal Stenosis

Abstract

Background: Hypospadias is a common congenital anomaly in males, with surgical correction being the primary treatment. The Snodgrass urethroplasty, or tubularized incised plate (TIP) urethroplasty, is widely used for distal and mid-penile hypospadias repair. However, postoperative complications such as urethrocutaneous fistula and meatal stenosis remain clinical concerns. Objective: To assess the postoperative complications of Snodgrass urethroplasty in pediatric patients with distal and mid-penile hypospadias. Study Design: Descriptive cross-sectional study. Setting: Conducted at Hayatabad Medical Complex, Peshawar, a tertiary care plastic surgery unit. Duration of Study: 04-07-2024 to 04-01-2025. Methods: A total of 80 male patients, aged 1–10 years, diagnosed with distal or mid-penile hypospadias through physical examination, were enrolled. All patients underwent Snodgrass urethroplasty. Postoperative complications, specifically urethrocutaneous fistula and meatal stenosis, were assessed on the 30th postoperative day. Data were analyzed using SPSS version 22.0, and frequencies and percentages were calculated. Results: The mean age of the cohort was 5.79 ± 2.68 years. Distal hypospadias accounted for 87.5% of cases, while mid-penile hypospadias comprised 12.5%. Urethrocutaneous fistula was observed in 12.5% of patients, and meatal stenosis occurred in 6.25%. Complications were more frequently noted among patients with mid-penile hypospadias compared to those with distal variants. Conclusion: Snodgrass urethroplasty is an effective technique for correcting distal and mid-penile hypospadias, with acceptable complication rates. Urethrocutaneous fistula (12.5%) and meatal stenosis (6.25%) were the most common postoperative issues, particularly in patients with mid-penile hypospadias. Early identification and management of these complications are essential to improving surgical outcomes.

References

Snodgrass WT. Consultation with the specialist: hypospadias. Pediatr Rev. 2004;25(2):63-7.

Bouty A, Ayers KL, Pask A, Heloury Y, Sinclair AH. The genetic and environmental factors underlying hypospadias. Sex Dev. 2016;9(5):239-59.

Keays MA, Dave S. Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes. Can Urol Assoc J. 2017;11(1):48.

Springer A, van den Heijkant M, Baumann S. Worldwide prevalence of hypospadias. J Pediatr Urol. 2016;12(3):152.

Elliott CS, Halpern MS, Paik J, Maldonado Y, Shortliffe LD. Epidemiologic trends in penile anomalies and hypospadias in the state of California, 1985–2006. J Pediatr Urol. 2011;7(3):294-8.

Duckett Jr JW. Hypospadias. Pediatrics in review. 1989;11(2):37-42.

Izairi A. Snodgrass urethroplasty-a standard technique for different types of hypospadia repair. Knowl Int J. 2021;48(3):415-9.

Borkar N, Tiwari C, Mohanty D, Singh S, Dhua A. The comparison of interrupted and continuous suturing technique in Snodgrass urethroplasty in patients with primary hypospadias: a systematic review and meta-analysis. Urol Ann. 2023;15(1):74-81.

Bakan V, Yildiz A. Dorsal double-layer dartos flap for preventing fistulae formation in the Snodgrass technique. Urol Int. 2007;78(3):241-4.

Pramod S, Anukethan J. Short term outcomes of snodgrass urethroplasty in distal and mid penile hypospadias. Int Surg J. 2018;5(5):1878-81.

Alsharbaini R, Almaramhy H. Snodgrass urethroplasty for hypospadias repair: A retrospective comparison of two variations of the technique. J Taibah Univ Med Sci. 2014;9(1):69-73.

Majid F, Siddique M, Yasmeen T, Tayyaba F, Zafar S, Attiq-ur-Rahman. Comparison of Outcome Complications between Snodgrass Technique and Mathieu’s Repair in Distal Hypospadias Repair. Med Forum. 2021;32(2):102-106.

Peyvasteh M, Askarpour S, Mohamadi A, Ilkhani Pak H. Evaluation of Complications and Effectiveness of Snodgraft Method on the Treatment of Distal Hypospadias or Midshaft. World J Plast Surg. 2022;11(1):38-43.

Roychoudhury A, Patra R, Saha S, Sinhababu A, Rangari P. A Clinical Study of Complications of Snodgrass Urethroplasty for Hypospadias. Int J Med Sci Diagn Res. 2019;3(4):63-72.

Jain AK, Sharma D, Charokar K. Snodgrass tubularized incised plate urethroplasty for distal penile hypospadias in paediatric age group: our experience. Int Surg J. 2016;3:217-20..

Sarma VP. The feasibility of urethral plate preservation in proximal and mid-penile hypospadias: sequential and anatomical approach to the repair. Ann Pediatr Surg. 2020 Sep 3;16(1).