The Meatal Mobilization (MEMO) Technique for distal Primary and Recurrent Hypospadias
Osama Ismail, Nawzat Hussein Mohammed, Moamin Junaid Salim
1318
ABSTRACTBackground: Hypospadias is one of the most common congenital anomalies of the male genito-urinary system. Hypospadias repair aims to provide excellent functional and cosmetic results. Urethral mobilization and advancement of the native urethra are considered a useful technique for distal hypospadias.Aim: To report our results in urethral mobilization and advancement in distal hypospadia management.Methods: A total of 76 patients with distal hypospadias were treated with meatal mobilization and advancement techniques during the study period between June 2015 and June 2019 in Al-Jadryia privet hospital in Baghdad. A description of the technique and postoperative results recorded.Results: A total of 76 patients included in this study, 69 had primary distal hypospadias, and seven patients previously failed distal hypospadias repair. The mean age at the time of operation was 20 months, and the mean operation time was 70 minutes. The only intraoperative complication was a urethral injury, which occurred in 5 patients. Postoperative hematoma developed in 4 patients, and three patients had a wound infection, and six patients had postoperative edema. However, all of them responded to conservative treatment. Urethrocutaneous fistula developed in 5 patients, the revision was needed in all of them. Meatal stenosis occurred in 4 patients; two of them responded well to gentle urethral dilatation, whereas the remaining 2 required meatotomy under general anesthesia. Meatal retraction, and mild residual chordee, were developed in 2, and 2 cases, respectively, and no further operative intervention was needed in the four patients. In all patients, the catheter was removed on the 5th postoperative day. The overall success rate was (93.4%).Conclusion Urethral mobilization technique resulted in excellent cosmetic and functional outcomes with a low complication rate. It is suitable for patients with distal hypospadias, including patients requiring redo urethroplasty. It has a low chance of urethrocutaneous fistula, especially in primary cases with low postoperative complications.Keywords: MEMO, urethral mobilization, distal hypospadias.
Background: Hypospadias is one of the most common congenital anomalies of the male genito-urinary system. Hypospadias repair aims to provide excellent functional and cosmetic results. Urethral mobilization and advancement of the native urethra are considered a useful technique for distal hypospadias.
Aim: To report our results in urethral mobilization and advancement in distal hypospadia management.
Methods: A total of 76 patients with distal hypospadias were treated with meatal mobilization and advancement techniques during the study period between June 2015 and June 2019 in Al-Jadryia privet hospital in Baghdad. A description of the technique and postoperative results recorded.
Results: A total of 76 patients included in this study, 69 had primary distal hypospadias, and seven patients previously failed distal hypospadias repair. The mean age at the time of operation was 20 months, and the mean operation time was 70 minutes. The only intraoperative complication was a urethral injury, which occurred in 5 patients. Postoperative hematoma developed in 4 patients, and three patients had a wound infection, and six patients had postoperative edema. However, all of them responded to conservative treatment. Urethrocutaneous fistula developed in 5 patients, the revision was needed in all of them. Meatal stenosis occurred in 4 patients; two of them responded well to gentle urethral dilatation, whereas the remaining 2 required meatotomy under general anesthesia. Meatal retraction, and mild residual chordee, were developed in 2, and 2 cases, respectively, and no further operative intervention was needed in the four patients. In all patients, the catheter was removed on the 5th postoperative day. The overall success rate was (93.4%).
Conclusion Urethral mobilization technique resulted in excellent cosmetic and functional outcomes with a low complication rate. It is suitable for patients with distal hypospadias, including patients requiring redo urethroplasty. It has a low chance of urethrocutaneous fistula, especially in primary cases with low postoperative complications.
Keywords: MEMO, urethral mobilization, distal hypospadias.