The Clinical Outcome of Repair in Distal Hypospadias; A Tertiary Care Single Centre Experience

Introduction:Hypospadias is a common congenital penile defect where the urethral opening is underdeveloped, causing physical and psychological distress.Distal hypospadias is the most prevalent type, with the meatus on the ventral surface.Surgical management is complex, with over 200 procedures attempted.The Tubularized Incised Plate (TIP) procedure, introduced by Snodgrass, is widely accepted for repairing distal hypospadias due to its superior cosmetic outcomes and low complications.Operating between 6 and 18 months is recommended to minimize stress, emphasizing the importance of the initial operation for optimal results. Aim of the study:This study aims to assess the outcome of distal hypospadias repair using the Snodgrass technique.Methods: This prospective observational study was conducted at a surgical inpatient department in Prime Hospital, UAE, focused on 15 distal hypospadias treated with Snodgrass urethroplasty.The study duration was 8 years from 2016 to 2024.Patients aged 6 months to 10 years were included, while those below 6 months or above 10 years, with previous genital operations, ambiguous genitalia, or significant surgical issues, were excluded.The TIP urethroplasty method was employed, with detailed surgical steps outlined.Postoperative assessments occurred at intervals of up to six months, evaluating outcomes and complications.Successful outcomes were defined, and data were analyzed using Microsoft Excel for descriptive statistics. Result:The study examines 15 pediatric patients with hypospadias, revealing an age distribution predominantly in the 2-4 age group, and the mean ± SD of the study is 5.26±1.2years.Chordee and meatal stenosis are prevalent in 66.67% and 53.33% of cases, respectively, with the distal shaft being the most common type.The average operation duration is 136.25±11.18minutes, demonstrating procedural consistency.Hospital stays averages 7.43±1.03days, indicating uniform postoperative recovery.Urethrocutaneous fistula is the primary postoperative complication at 13.33%, followed by wound infection (6.67%), glandular dehiscence (6.67%), and meatal stenosis (6.67%).The findings underscore the anatomical diversity of hypospadias, emphasizing the importance of tailored approaches for optimal outcomes. Conclusion:The outcome of Snodgrass repair in distal hypospadias is satisfactory with acceptable complications.However, a 33.33% complication rate, mainly urethrocutaneous fistula and meatal stenosis, underscores the need for ongoing surgical skill improvement.