Skip to main content

Advertisement

SpringerLink
Log in

Outcome of Snodgrass Repair for Various Types of Hypospadias: Our Experience

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Hypospadias is the most common congenital malformation, affecting 1 in 200–300 newborn males. No single procedure is standard for all types of hypospadias. Our objective is to assess our skill and report our experience in terms of feasibility and result of Snodgrass repair for various types of hypospadias. We analyzed 97 cases of hypospadias with or without chordee with adequate urethral plate who underwent Snodgrass repair from 2009 to 2014 by single surgeon. Age ranges at the time of surgery from 18 months to 28 years. Common site was distal penile in 42 cases (40.74%) followed by mid-penile in 32 cases (31.04%). Twenty-five patients had clinically notable chordee. Technique involved incision of urethral plate up to mid-glans and continuous uninterrupted subcuticular suture technique with PDS for urethroplasty with use of various second layers as per need and availability. Overall complication rate was 7.76%. Overall success rate was 92.24%. Complications include meatal stenosis, superficial skin blackening, complete dehiscence, and hematoma one each, and four cases had urethrocutaneous fistula. Patients were cosmetically and functionally normal with maximum follow-up of 5 years. TIP is a novel and an attractive single-stage technique due to its adaptability, relative ease, and low complication rate for anterior hypospadias. Its use can be extended in mid- and proximal hypospadias where degloving only is sufficient for orthoplasty.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ikaram ud Din O, Yunas M (2008) Snodgrass repair of anterior hypospadias. JPMI 22(01):13–16

    Google Scholar 

  2. Khairi A (2012) Snodgrass repair for distal hypospadias: a review of 75 cases. Ann Pediatr Surg 8:12–14

    Article  Google Scholar 

  3. Dhua AK, Agrawal SK, Sinha S, Ratan SK (2012) Soft tissue cover in hypospadias surgery: is tunica vaginalis better than dartos flap? J Indian Assoc Pediatr Surg 17(1):16–19

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mohajerzadeh L, Ghoroubi J, Roshanzamir F, Alizadeh H (2015) Outcome of tubularised incised plate (TIP) urethroplasty: a single center experience with 307 cases. Iran J Padiatr Surg 1:No. 1

    Google Scholar 

  5. Sharma GR (2004) Tubularised incised plate urethroplasty (TIP) for distal and midshaft hypospadias a preliminary experience. Indian J Urol 20(2):15–18

    Google Scholar 

  6. Kamal A, Khan K, Ayub M (2015) Surgical management of anterior hypospadias: our experience with Snodgrass repair technique. Gomal J Med Sci 13:No.1

    Google Scholar 

  7. Bhat A, Mandal AK (2008) Acute postoperative complications of hypospadias repair. Indian J Urol 24(2):241–248

    Article  PubMed  PubMed Central  Google Scholar 

  8. Aydogdu B, Okur MH, Zeytun H, Otcu S (2015) Megameatus with intact prepuce (MIP) hypospadias variant applicated tubularised incised plate(TIP) urethroplasty: a case report. Ped Urol Case Rep 2(6):15–19

    Article  Google Scholar 

  9. Ryan AK, Goodship JA, Wilson DI, Philip N, Levy A, Seidel H, Schuffenhauer S, Oechsler H, Belohradsky B, Prieur M, Aurias A, Raymond FL, Clayton-Smith J, Hatchwell E, McKeown C, Beemer FA, Dallapiccola B, Novelli G, Hurst JA, Ignatius J, Green AJ, Winter RM, Brueton L, Brondum-Nielsen K, Scambler PJ (1997) Spectrum of clinical features associated with interstitial chromosome 22q11 deletions: a European collaborative study. J Med Genet 34:798–904

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. O’Connor KM, Kiely EA Lessons learned using Snodgrass hypospadias repair. Ir J Med Sci 175:No1

  11. Bath AS, Bhandari PS, Mukherjee MK (2003) Repair of distal hypospadias by the tubularised incised plate urethroplasty: a simple versatile technique. Indian J Plast Surg 36(1):23–25

    Google Scholar 

  12. Yassin T, Bahaaeldin KH, Husein A, El Minawi H (2011) Assessment and management of urethrocutaneous fistula developing after hypospadias repair. Ann Padiatr Surg 1687–4137

  13. El Saket HA, Fares A, Kaddah SN (2008) Tubularised incised plate urethroplasty for midpenile and more proximal hypospadias repair. Ann Pediatr Surg 4(3&4):94–99

    Google Scholar 

  14. Attar FS (2009) Evaluation of the tubularised incised plate urethroplasty (TIP) for repair f distal hypospadias. Bas J Surg 15

  15. Khan WY, Alam M, Islam F, Israr M (2014) Surgical management of anterior hypospadias, our experience with Snodgrass repair technique. Pak J Surg 30(3):248–251

    Google Scholar 

  16. Bar Yosef Y, Binyamini J, Mullerad M, Matzkin H (2005) Megameatus intact prepuce hypospadias variant: application of tubularised incised plate urethroplasty. Urology 66:B61–B64

    Article  Google Scholar 

  17. Uiman I, Erikei V, Avanoglu A, Gokdemir A (1997) The effect of suturing technique and material on complication rate following hypospadias repair. Eur J Padiatr Surg 7:156–157

    Article  Google Scholar 

  18. Hombalkar NN, Gurav PD, Dhandore PD, Parmar RR (2013) Snodgrass procedure—a versatile technique for variant types of hypospadias repair. JKIMSU 2:2

    Google Scholar 

  19. Kamal AM, Abou Hashem SE, Yossef HK (2005) Tubularised incised plate (TIP) urethroplasty: extended use in hypospadias re-operation. Afr J Urol 11(1):15–21

    Google Scholar 

  20. Chatterjee US, Mandal MK, Basu S, Das R, Majhi T (2004) Comparative study of dartos fascia and tunica vaginalis pedicle wrap for the tubularised incised plate in primary hypospadias repair. BJU Int 9:1102–1104

    Article  Google Scholar 

  21. Yerkes EB, Adams MC, Miller DA, Pope JC 4th, Rink RC, Brock JW 3rd (2000) Y to I wrap: use of the distal spongiosum for hypospadias repair. J Urol 163:1536–1538

    Article  CAS  PubMed  Google Scholar 

  22. Dodat H, Landry JL, Szwarc C, Culem S, Murat FJ, Dubois R (2003) Spongioplasty and separation of the corpora cavernosa for hypospadias repair. BJU Int 91:528–531

    Article  CAS  PubMed  Google Scholar 

  23. Bhat A, Sabharwal K, Bhat M, Saran R, Singla M, Kumar V (2014) Outcomes of tubularised incised plate urethroplasty with spongioplasty alone as additional tissue cover: a prospective study. Indian J Uro 30(4):392–397

    Article  Google Scholar 

  24. Holland AJ, Smith GHH (2000) Effect of depth and width of urethral plate on tubularised incised plate urethroplasty. J Urol 64:489

    Article  Google Scholar 

  25. Snodgross W, Villanueva C, Bush NC (2014) Duration and follow-up to diagnose hypospadias urethroplasty complications. J Pediatr Urol 10(2):208–211

    Article  Google Scholar 

  26. Elbakry A, Shamaa M, Al-Atrash G (1998) An axially vascularised meatal based flap for the repair of hypospadias. Br J Urol 82:698–703

    Article  CAS  PubMed  Google Scholar 

  27. Horton CE, Horton CE Jr (1988) Complications of hypospadias surgery. In: Horton CE (ed) Clinics in plastic surgery. WB Saunders Company, Philadelphia, p p371

    Google Scholar 

  28. Snodgross W, Koyle M, Manzoni G, Hurwitz R, Caldamone A, Ehrlich R (1996) Tubularised incised plate hypospadias repair: results of multicenter experience. J Urol 156(2Pt2):839–841

    Google Scholar 

  29. Elbakry A (1999) Tubularised incised plate urethroplasty: is regular dilatation necessary for success? BJU Int 84:683–688

    Article  CAS  PubMed  Google Scholar 

  30. Lorenzo AJ, Snodgross WT (2002) Regular dilatation is unnecessary after tubularised incised plate hypospadias repair. BJU Int 89:94–97

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India

    Venkat A. Gite, S. M. Bote, J. V. Nikose & S. R. Patil

  2. Aurangabad, India

    Venkat A. Gite

  3. Department of General Surgery, Government Medical College, Aurangabad, Maharashtra, India

    A. J. Kandi

Authors
  1. Venkat A. Gite
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. J. Kandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. M. Bote
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. V. Nikose
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. R. Patil
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Venkat A. Gite.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gite, V.A., Kandi, A.J., Bote, S.M. et al. Outcome of Snodgrass Repair for Various Types of Hypospadias: Our Experience. Indian J Surg 81, 216–220 (2019). https://doi.org/10.1007/s12262-018-1768-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-018-1768-6

Keywords

Search

Navigation