CONTRIBUTION OF SNODGRASS REPAIR IN HYPOSPADIAS SURGERY

ABSTRACT
Study Design: Descriptive Case Series
Place and Duration: Plastic surgery clinic, Aman hospital Dabgari Garden Peshawar from Dec.2012 to Dec. 2015.
Material and Methods: Patients with distal and mid penile primary hypospadias with no or minimal chordee and with
adequate uretheral plate were included. Patients were examined pre operatively in supine position for meatus location,
chordee, circumcision status and uretheral plate width and documented photographically. Patients were operated by
the same senior Plastic surgeon. Postoperatively, same parameters along with glans configuration, urethro cutaneous
fistula, urinary stream and meatal stenosis were observed along with patient’s parent satisfaction.
Results: A total of 40 patients were included in this study. Mean age at surgery was 28 months with range from 24 to
72 months. Vertical slit like meatus was achieved in 35 (87.5%) patients, round in 2 (5%) and a conical glans in 38(95%)
patients. Meatal stenosis was noticed in 3(7.5%) while urethrocutaneous fistula in 3(7.5%) patients. The final cosmetic
result was considered good or satisfactory in 38(95%) cases.
Conclusion: This technique proves itself to be more promising tool in the armamentarium of Plastic and Paediatric
surgeons especially for distal and mid penile hypospadias with minimal chordee keeping in view obviously the adequate
uretheral plate width. However, further randomized controlled trials are needed to confirm its contribution especially for
proximal hypospadias and with severe chordee of more than 30 degrees.
Key words: Hypospadias, Snodgrass repair, chordee, uretheral plate, slit like meatus