Use of an inner preputial free graft to extend the indications of Snodgrass hypospadias repair (Snodgraft)

Urethroplasty for failed hypospadias repair: A matched cohort analysis

“…For very complicated strictures with poor quality of the remaining urethral plate, a two-stage urethroplasty was performed. In failed hypospadias repair, we augmented the remaining urethral plate with a dorsal free graft during the first stage ('snodgraft technique' [4]). …”

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes

“…41 However, alternative UP augmentation techniques have been used selectively in cases with poor UP quality. An inner preputial free graft, referred to as a "Snodgraft" 42 procedure places a preputial inlay graft on the incised surface of the UP with the premise that a graft covering a deep UP incision would decrease scarring. The Mathieu procedure flips a rectangular piece of foreskin distally, which is sutured to the edges of the UP on either side as an onlay flap to the UP.…”

Assessment of urethral plate appearance through digital photography: Do pediatric urologists agree in their visual impressions of the urethral plate in children with hypospadias?

“…Indeed, the plate characteristics may be critical in only a small minority of patients with distal hypospadias, and other conditions e such as the presence and degree of ventral curvature e have a potentially greater impact on technique selection. Nevertheless, the need to address an unfavorable plate at the time of distal hypospadias repair has been the driving force behind modifications to the TIP technique, such as the inlay graft augmentation ('Snodgraft'), which was offered to w10% of patients in a recent report from a busy academic center [18]. Conversely, plate characteristics appear to gain greater importance in proximal cases, as shown by the presented results (Figs.…”