Abstract

Objective: To evaluate the results of Snodgrass repair in hypospadias in our hand and at the same time identify cases not fit for this procedure.

Place and Duration: In the Surgical Units of Sir Gang Ram hospital, Lahore for one year duration from March 2019 to March 2020.

Materials and methods: 60 patients with proximal, coronal and sub-coronal hypospadias underwent surgical repair. Snodgrass repair was done in 30 cases (11 coronal and 19 sub-coronal), and Bracka II stage in 30 cases (26 proximal and 4 sub-crown). All cases in the Bracka stage II group whose Chordee were corrected by preputial skin transplantation. The second stage of urethroplasty was carried out at least 6 months after the first stage.

Results: Thirty patients (50%) had normal meatal position, normal glanular anatomy, well defined coronal sulcus, normal cylindrical shaft and voided from the tip with very good cosmetic and functional results, ten patients (16.6%) developed meatal stenosis, nineteen patients (31.6%) urethrocutaneous fistula, eleven patients (18.3%) developed wound infection, four patients (6.6%) developed stricture. Meatal stenosis patients responded well to periodic dilation, fistula needs surgical intervention, wound infection responded well with daily dressing, stricture initially responded well with periodic dilatation later two patient’s needs surgical intervention.

Conclusion: Snodgrass repair offers optimal repair of distal and middle hypospadias with low complication rate and excellent cosmetic result. Progressive repair is a safe and reliable approach in selected patients, in which the urethral plaque cannot be combined with the repair, and therefore requires replacement.

Keywords: Snodgrass repair, Bracka repair, hypospadias, meatal stenosis