SNODGRASS REPAIR OF ANTERIOR HYPOSPADIAS

Abstract

Objective: To know the outcome of Snodgrass technique for the repair of anterior hypospadias.

Material and Methods: This study was conducted at Aman Hospital Peshawar from January 2004 to

January 2007 on patients with anterior hypospadias with or without chordee. The entire length of the

urethral plate was incised along the midline and the neourethra was tubularized over a 6 or 8 Fr

catheters. The chordee usually disappeared after the penis was degloved. Dorsal plication was performed

in mild residual chordee. A subdartos fascial flap was created to cover the neourethra and pressure

dressing applied with gauze for 7 days. The urethral catheter was removed on the 7th post-operative day.

Results: The Snodgrass technique was performed in 50 boys, age range from 2-10 years with a mean age

of 3.73 years. The operative time was 45-100 minutes. There were 35 distal penile and 15 midshaft

hypospadias. All the patients had excellent cosmetic appearance. The pinhole fistulas were noted in 04

(8%) cases which closed spontaneously after 06 months. A large fistula was noted in 01 case (2%) which

was repaired successfully after 6 months. Only 03(6%) cases had a mild degree of meatal stenosis which

responded to meatal dilatation. The dehiscence of glans occurred in 02 (4%) cases which were successfully

repaired. No urethral stricture was noticed during 6 months follow-up.

Conclusion: The Snodgrass repair in the management of anterior hypospadias is simple technique having

excellent cosmetic and functional results with low complication rate.