Comparative Analysis of Surgical Methods for Distal, Mid-, and Proximal Shaft Hypospadias in Young Males: A Prospective Study on Postoperative Outcomes

Abstract

Background and Objectives: The purpose of this study is to report on the results of hypospadias surgery in boys using newly developed methods compared with traditional methods of urethroplasty. Materials and Methods: A total of 136 patients were divided into two groups. Fifty patients with coronal, subcoronal, and distal penile types of hypospadias were allocated to Group I. These patients were treated with a new method of SMU I and urethroplasty according to the Snodgrass procedure and MAGPI. Group II consisted of 86 patients with mid- and proximal shaft penile types of hypospadias who underwent urethroplasty using the new SMU II method and urethroplasty according to the Snodgraft and Bracka procedures. The outcomes were assessed according to the level of postoperative wound healing and the presence of complications. Results: The mean age of the patients was 41 to 60 months. After urethroplasty using the SMU I and SMU II methods, recovery was noted in 92.9% of the patients, and repeated surgery was performed in 7.1%. In the patients undergoing operations utilizing the SMU I and SMU II methods, neomeatus dystopia was not detected and postoperative fistulas were observed in 16.7% of incidence. With the standard urethroplasty method, the rate of complications was higher (p < 0.05). Even though the duration of surgery in the group undergoing a procedure using the standard urethroplasty method was lower (p < 0.001), the frequency of primary wound healing was higher in the SMU I and SMU II groups (p < 0.001). Conclusions: The proposed new methods of distal and shaft hypospadias surgery, in comparison with traditional surgical techniques, have the following advantages: good cosmetic appearance of the penis, complete straightening of the shaft, and right outflow of urine through the slit-like neomeatus at the apex of the glans penis.