Mansoor K, Tsang T, Okoro PE. Preservation of glanular cleft in the configuration of a vertical slit neomeatus in modified mathieu hypospadias repair.
Afr J Paediatr Surg 2019;
16:10-13. [PMID:
32952133 PMCID:
PMC7759077 DOI:
10.4103/ajps.ajps_67_17]
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Abstract
BACKGROUND
The aim of this study is to review the results of modified Mathieu's repair in a single surgeon's series. The technique involved preserving the apical part of the glanular cleft including the lips, part of the un-formed glanular meatus in the reconstruction of a vertical slit neomeatus. The achievement of a vertical slit neomeatus was critically assessed.
MATERIALS AND METHODS
A retrospective analysis was carried out for all cases of Mathieu's repair done by a single surgeon over the past 22 years (1995-2017). Inclusion criteria included all cases of coronal, subcoronal and distal penile hypospadias. Cases done as redo secondary Mathieu's procedure were also included irrespective of the type of primary procedure.
RESULTS
A total of 97 cases fulfilled the inclusion criteria. 91 patients had a primary Mathieu's procedure. Six patients had a Mathieu's repair as a secondary operation. The complications included 4 fistulas (4.12%), 3 meatal retractions (3.09%) and 2 mild stenosis (2.06%). There were no breakdowns of the repair Ninety-four patients (96.90%) had a glanular vertical slit neomeatus. This included patients with a fistula and both patients with mild stenosis. All fistulas were successfully closed in a single attempt. Four patients (4.12%) had a slight splaying of the lower end of the meatus and three circular neomeatus (3.09%). Both cases of stenosis responded well to dilatation.
CONCLUSION
Mathieu's repair is an old and time-tested technique used in surgery of distal hypospadias. With modification aiming to preserve the apical part of the glanular cleft adopted, a vertical slit neomeatus can be achieved readily as shown by our series and major complications appear rather uncommon.
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