Publication:

Comparative study between modified Mathieu technique and tubularized incised plate technique in primary repair of distal hypospadias

Background Hypospadias is a congenital anomaly in which the urethral opening is located on the ventral surface of the penis proximal to the glans tip. Among various surgical options, tubularized incised plate (TIP) urethroplasty is widely used. However, anatomical factors such as a narrow urethral plate and shallow glans may limit its success and increase complications. A modified technique combining features of TIP and the Mathieu procedure has been proposed to address these limitations. This study aimed to compare outcomes of the Modified Mathieu (Mathieu-IP) technique and TIP urethroplasty in primary distal hypospadias repair.

Methods This study was conducted at DMCH from January 2021 to June 2022, including 44 patients aged 1-12 years with primary distal hypospadias. Patients were purposively divided into two groups: 22 underwent the Modified Mathieu technique and 22 underwent TIP repair. Follow-up was done on postoperative days 7 and 14, and at 1 and 3 months (excluding four patients lost to follow-up). Data on perioperative variables and complications were analyzed using Student’s t-test, Chi-square test, and Fisher’s exact test, with p<0.05 considered significant.

Results No significant difference was observed in neo-meatus formation. Meatal stenosis occurred in two (10%) TIP patients. Urethrocutaneous fistula was seen in five (25%) TIP patients and three (15%) Modified Mathieu patients. Splayed urinary stream occurred in 15% and 25% of patients, respectively, while 10% of TIP patients had a narrow stream. These differences were not statistically significant (p=0.219).

Conclusions No significant difference was found between the Modified Mathieu and TIP techniques in primary distal hypospadias repair.