Functional evaluation of mid and distal penile hypospadias surgery with special reference to uroflowmetry

Abstract

Background: To assess two different operative techniques in hypospadias with special emphasis on urinary flow with the help of uroflowmetry. Material and Methods: In this prospective study, all patients underwent either Snodgrass or Mathieu urethroplasty. Preoperative uroflowmetry was done in every patient. Postoperative uroflowmetry was done 2 weeks after stitch removal only in those patients who were not having urethral fistula. Postoperative dilation was done only in those patients who had decreased urinary flow as compared to preoperative values. Results: Fifty patients were included in this 2-year study. Uroflowmetry was performed in 37 patients. Twenty-two patients underwent Snodgrass urethroplasty and the other 15 had Mathieu urethroplasty. Pre- and postoperative Qmax values were 6.57 ± 2.67 and 7.36 ± 3.90 ml/s, respectively. Qavg values were 4.16 ± 1.87 and 4.52 ± 2.50 ml/s, respectively. Although statistically insignificant, the Snodgrass technique appeared to be relatively better than Mathieu's technique. Conclusion: Uroflowmetry can predict the need for dilation in hypospadias. The Snodgrass technique appears to be functionally better than Mathieu's technique. With avoidance of unnecessary trauma due to dilation, the cooperation of pediatric patients can be achieved. © 2011 S. Karger AG, Basel.