Comparative analysis of tubularized incised plate and Mathieu’s procedure for primary hypospadias repair: A tertiary care single center study

Background: Hypospadias is a congenital condition marked by ventral penile tissue hypoplasia. The most commonly used single-stage procedures for distal hypospadias repair are the tubularized incised plate (TIP or Snodgrass) and Mathieu’s procedure. Objective: To compare early and late postoperative complications between TIP and Mathieu’s procedures for primary distal hypospadias repair. Materials and Methods: This prospective observational study was conducted in the Department of Urology, SMS Medical College, Jaipur, from January 2023 to January 2024. Thirty patients with primary distal hypospadias were divided into two groups: Group I (TIP repair) and Group II (Mathieu’s repair), with 15 patients each. Preoperative assessment included history and local examination of meatal location, glans configuration, and presence of chordee. All patients were followed up for 3 months postoperatively. Results: The mean age of presentation was 6.2 ± 3.2 years. The mean operative time was 62.4 ± 8.8 min and 65 ± 10 min in Mathieu’s repair and TIP, respectively. Postoperative complications included urethro-cutaneous fistula in four patients (26.6%) in the TIP group and two patients (13.3%) in Mathieu’s group; meatal stenosis and wound infection occurred in one case (6.66%) each in both groups ( P = 0.65). Conclusion: Although TIP is widely used, our study found that Mathieu’s procedure had fewer early complications and offered better early outcomes. Metacarpophalangeal joint remains a safe and effective technique for primary distal hypospadias repair, with excellent cosmesis and reduced complication rates.