Tubularization of the incised urethral plate (Snodgrass procedure) for primary hypospadias surgery

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<jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the Snodgrass procedure for patients with hypospadias who have not undergone previous surgery and whose urethral plate is too narrow for tubularization alone.</jats:p></jats:sec><jats:sec><jats:title>Patients and methods</jats:title><jats:p>Thirty‐two boys (mean age 18 months) underwent primary hypospadiac surgery performed by one surgeon (P.S.M.). Twenty‐five boys had a distal hypospadias (coronal, subcoronal) and seven had a more proximal defect (penile shaft, penoscrotal). The operation involved incision of the urethral plate, which was then tubularized (Snodgrass procedure). The neourethra was then covered with a de‐epithelialized pedicled dartos flap from the inner prepuce before glans and skin closure.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>With a mean follow‐up of 10 months (range 2–14) there were two complications; one child with a coronal hypospadias developed a fistula whist one with a penile shaft defect had complete breakdown of the neourethra. The cosmetic appearance in the other 30 patients is that of a normal slit‐like terminal meatus.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Tubularization of the incised urethral plate is a safe advance in the surgery of hypospadias. We recommend it for both distal and proximal defects, in patients where the urethral plate is insufficient for tubularization alone.</jats:p></jats:sec>

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