CC BY-NC-ND 4.0 · Indian J Plast Surg 2015; 48(01): 048-053
DOI: 10.4103/0970-0358.155269
Original Article
Association of Plastic Surgeons of India

Comparative study of Mirs’(Mushtaq and Shabir) technique of prepuce preserving minimally invasive urethroplasty with Snodgrass urethroplasty for repair of distal hypospadias without chordee…A prospective study

Mushtaq Mir
Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India
,
Shabir Ahmad Mir
Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India
,
Muddassir Shahdhar
Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India
,
Mumtazdin Wani
Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India
,
Hakim Adil Moheen
1   University of Kashmir, Srinagar, Jammu and Kashmir, India
,
Jahangeer Ahmad Bhat
2   Department of Radiodiagonosis, Government Medical College, Srinagar, Jammu and Kashmir, India
› Author Affiliations
Further Information

Address for correspondence:

Dr. Shabir Ahmad Mir
Department of Surgery, Government Medical College
Srinagar, Jammu and Kashmir
India   

Publication History

Publication Date:
26 August 2019 (online)

 

ABSTRACT

Background: There is no single, universally applicable technique for hypospadias repair and numerous techniques have been practised from time to time. We compare the results of our new technique (Mirs’ technique also called Mush & Shab’s technique) to Snodgross urethroplasty. Mirs’ technique is a modified version of Thiersch-Duplay urethroplasty. Material and Methods: This prospective comparative study was carried out in a tertiary care hospital of Northern India over a period of 3 years from March 2010 to March 2013 and included 120 patients of anterior (distal penile, subcoronal, coronal and glanular) hypospadias without chordee. They underwent either Mirs’ technique (group 1 n = 60) or Snodgrass technique (group 2 n = 60). Follow-up was at 1-week, 1-month, 3 months and 6 months. Results: The mean operative time was 55 min (range: 43-70 min) in group 1 and 71.9 min (range: 60-81 min) in group 2 (P & 0.001). Urethrocutaneous fistula developed in two and four patients in group 1 and 2, respectively. Fistula closure was done at least 3 months postoperatively, and there was no significant difference in success rate between the two groups. Three cases of glanular dehiscence were detected (one in group 1 and two in group 2); the patient from group 1 had a successful repair using the already preserved prepuce. Conclusion: Mirs’ modification of Thiersch-Duplay technique for distal hypospadias is a time saving procedure with a lower overall complication rate. Valuable local tissue is preserved to deal with any complication that may occur. Analgesic requirement was significantly lower in this minimally traumatic technique. As it is less time consuming, simple and easy to learn with a short learning curve, this technique deserves application in cases of distal hypospadias.


#

 


#

Conflicts of interest

None declared.

  • REFERENCES

  • 1 Devine Jr CJ, Allen TD, Duckett JW, Horton CE. Hypospadias. Dial Ped Urol 1978; 1: 2-4
  • 2 Mitchell ME, Kulb TB. Hypospadias repair without a bladder drainage catheter. J Urol 1986; 135: 321-3
  • 3 Snodgrass W. Tubularized, incised plate urethroplasty for distal hypospadias. J Urol 1994; 151: 464-5
  • 4 Brekalo Z, Kvesiæ A, Nikoliæ H, Tomiæ D, Martinoviæ V. Snodgrass’ urethroplasty in hypospadias surgery in Clinical Hospital Mostar - Preliminary report. Coll Antropol 2007; 31: 189-93
  • 5 Snodgrass W. Changing concepts in hypospadias repair. Curr Opin Urol 1999; 9: 513-6
  • 6 Samuel M, Capps S, Worthy A. Distal hypospadias: which repair?. BJU Int 2002; 90: 88-91
  • 7 Al-Hunayan AA, Kehinde EO, Elsalam MA, Al-Mukhtar RS. Tubularized incised plate urethroplasty: Modification and outcome. Int Urol Nephrol 2003; 35: 47-52
  • 8 Soygur T, Arikan N, Zumrutbas AE, Gulpinar O. Snodgrass hypospadias repair with ventral based dartos flap in combination with mucosal collars. Eur Urol 2005; 47: 879-84
  • 9 Turial S, Enders J, Engel V, Schier F. Stent-free tubularized incised plate (TIP) repair of distal and mid-shaft hypospadias irrespective of age. Eur J Pediatr Surg 2011; 21: 168-70
  • 10 Sozubir S, Snodgrass W. A new algorithm for primary hypospadias repair based on tip urethroplasty. J Pediatr Surg 2003; 38: 1157-61
  • 11 Jayanthi VR. The modified Snodgrass hypospadias repair: Reducing the risk of fistula and meatal stenosis. J Urol 2003; 170: 1603-5
  • 12 Oswald J, Körner I, Riccabona M. Comparison of the perimeatal-based flap (Mathieu) and the tubularized incised-plate urethroplasty (Snodgrass) in primary distal hypospadias. BJU Int 2000; 85: 725-7
  • 13 Roy SK, Saha K, Bhattacharjee PK, Majhi TK. Short term results of snodgrass tubularized incised plate urethroplasty in distal and mid penile hypospadias. J Indian Assoc Pediatr Surg 2003; 8: 226-30
  • 14 Shahzad Saleem M, Rasool M, Pansota MS, Tabassum SA. Comparative study between tubularized incised plate (Snodgrass) urethroplasty and reverse flap (Mathieu’s) repair in distal hypospadias. Ann Pak Inst Med Sci 2012; 8: 96-100
  • 15 Guo Y, Ma G, Ge Z. Comparison of the Mathieu and the Snodgrass urethroplasty in distal hypospadias repair. Zhonghua Nan Ke Xue 2004; 10: 916-8
  • 16 Alsharbaini R, Almaramhy H. Snodgrass urethroplasty for hypospadias repair: A retrospective comparison of two variations of the technique. Journal of Taibah University Medical Sciences 2014; 9: 69-73

Address for correspondence:

Dr. Shabir Ahmad Mir
Department of Surgery, Government Medical College
Srinagar, Jammu and Kashmir
India   

  • REFERENCES

  • 1 Devine Jr CJ, Allen TD, Duckett JW, Horton CE. Hypospadias. Dial Ped Urol 1978; 1: 2-4
  • 2 Mitchell ME, Kulb TB. Hypospadias repair without a bladder drainage catheter. J Urol 1986; 135: 321-3
  • 3 Snodgrass W. Tubularized, incised plate urethroplasty for distal hypospadias. J Urol 1994; 151: 464-5
  • 4 Brekalo Z, Kvesiæ A, Nikoliæ H, Tomiæ D, Martinoviæ V. Snodgrass’ urethroplasty in hypospadias surgery in Clinical Hospital Mostar - Preliminary report. Coll Antropol 2007; 31: 189-93
  • 5 Snodgrass W. Changing concepts in hypospadias repair. Curr Opin Urol 1999; 9: 513-6
  • 6 Samuel M, Capps S, Worthy A. Distal hypospadias: which repair?. BJU Int 2002; 90: 88-91
  • 7 Al-Hunayan AA, Kehinde EO, Elsalam MA, Al-Mukhtar RS. Tubularized incised plate urethroplasty: Modification and outcome. Int Urol Nephrol 2003; 35: 47-52
  • 8 Soygur T, Arikan N, Zumrutbas AE, Gulpinar O. Snodgrass hypospadias repair with ventral based dartos flap in combination with mucosal collars. Eur Urol 2005; 47: 879-84
  • 9 Turial S, Enders J, Engel V, Schier F. Stent-free tubularized incised plate (TIP) repair of distal and mid-shaft hypospadias irrespective of age. Eur J Pediatr Surg 2011; 21: 168-70
  • 10 Sozubir S, Snodgrass W. A new algorithm for primary hypospadias repair based on tip urethroplasty. J Pediatr Surg 2003; 38: 1157-61
  • 11 Jayanthi VR. The modified Snodgrass hypospadias repair: Reducing the risk of fistula and meatal stenosis. J Urol 2003; 170: 1603-5
  • 12 Oswald J, Körner I, Riccabona M. Comparison of the perimeatal-based flap (Mathieu) and the tubularized incised-plate urethroplasty (Snodgrass) in primary distal hypospadias. BJU Int 2000; 85: 725-7
  • 13 Roy SK, Saha K, Bhattacharjee PK, Majhi TK. Short term results of snodgrass tubularized incised plate urethroplasty in distal and mid penile hypospadias. J Indian Assoc Pediatr Surg 2003; 8: 226-30
  • 14 Shahzad Saleem M, Rasool M, Pansota MS, Tabassum SA. Comparative study between tubularized incised plate (Snodgrass) urethroplasty and reverse flap (Mathieu’s) repair in distal hypospadias. Ann Pak Inst Med Sci 2012; 8: 96-100
  • 15 Guo Y, Ma G, Ge Z. Comparison of the Mathieu and the Snodgrass urethroplasty in distal hypospadias repair. Zhonghua Nan Ke Xue 2004; 10: 916-8
  • 16 Alsharbaini R, Almaramhy H. Snodgrass urethroplasty for hypospadias repair: A retrospective comparison of two variations of the technique. Journal of Taibah University Medical Sciences 2014; 9: 69-73