Background: Hypospadias is the second most common congenital malformation and may be classified according to the anatomical site of urethral meatus into distal, which accounts for about 70-80% of all hypospadias cases, and proximal, which is rare. There are multiple surgical options for the management of hypospadias. This study covers cases of distal hypospadias with two surgical options, which are urethral advancement and Glanuloplasty, and meatal advancement glanuloplasty.
Objectives: To compare the surgical outcomes and complications of urethral advancement and meatal advancement with glanuloplasty for the treatment of distal hypospadias.
Methods: Forty-three patients, 20 of whom underwent meatal advancement and glanuloplasty and 23 underwent urethral advancement glanuloplasty, were followed up for 6 months after the operation at Ghazi Al-Hariri Hospital, Medical City Complex, Baghdad, Iraq, for the surgical speciality during the period from April 2017 to March 2020.
Results: The mean age of the meatal advancement and glanuloplasty group at surgery was (35.5+17.31 months) which was comparable to that of the urethral advancement glanuloplasty group (37.5+14.27 months) with no significant difference. There were no significant differences between the groups in operative time, which was 35.16+2.9 min in urethral advancement glanuloplasty and 30.72+3.2 min in meatal advancement and glanuloplasty. Six complications were reported in this study, four of which (two meatal stenosis
and 2 wound dehiscence) occurred in the meatal advancement and glanuloplasty group, while two complications (one meatal stenosis and one meatal retraction) occurred in the urethral advancement glanuloplasty group.
Conclusions: Urethral advancement glanuloplasty is a safe and effective alternative surgical option for the treatment of patients with distal hypospadias, especially those with a non-mobile meatus, with the same rate of complications.