
Outcome of Mathieu Meatal-based Flip Flap Technique for Distal Hypospadias: A Retrospective Cohort Study from a Single Tertiary Care Centre, Bhubaneswar, India
Correspondence Address :
Dr. Subrat Kumar Mohanty,
Professor and Head, Department of Paediatric Surgery, Kalinga Institute of Medical Sciences, KIIT Road, Campus 5, Bhubaneswar-751024, Odisha, India.
E-mail: subrat.mohanty@kims.ac.in
Introduction: Several surgical procedures are used for the correction of distal hypospadias. Institutional protocols vary regarding the ideal procedure. The goal of modern hypospadias surgery is to achieve a functionally and cosmetically normal penis. Mathieu described a technique that utilises the perimeatal skin proximally to create a flap for the repair of distal hypospadias. It is a time-tested method with minimal complications.
Aim: To highlight the incidence of complications and the surgical outcomes of distal hypospadias using Mathieu’s meatal-based flip flap technique.
Materials and Methods: A retrospective cohort study was conducted in the Department of Paediatric Surgery at a tertiary care hospital at the Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India on 55 children aged 2-16 years from January 2021 to August 2024. The study population included children with distal penile hypospadias with or without mild skin-level chordee. Patients underwent surgery using the Mathieu meatal-based flip flap technique. The length of the skin flap was determined by the distance from the meatus to the glans tip, after which a ventral meatal-based skin flap was incised. The maximum flap length used was 2 cm. The proximal flap was dissected from the underlying urethra, flipped distally, and anastomosed to the distal urethral plate with running subcuticular sutures of 6-0 Polydiaxanone. The urethra was stented using an infant feeding tube for eight days, and the dressing with the catheter was removed on postoperative day 9. Postoperative complications were analysed using descriptive statistics of frequency and percentage.
Results: The mean age at the time of urethroplasty was 6.6±3.2 years. Out of 55 patients, 1 (1.8%) developed meatal stenosis, 1 (1.88%) developed a urethrocutaneous fistula, 2 (3.6%) experienced meatal regression, and 3 (5.4%) had glans dehiscence. All patients (and their caregivers) were satisfied with the cosmetic and functional outcomes postoperatively during follow-up.
Conclusion: In present study, Mathieu’s meatal-based flip flap urethroplasty resulted in successful outcomes with low complications. Thus, Mathieu’s meatal-based flip flap urethroplasty remains a time-tested and effective method for select cases of distal hypospadias.
Meatal stenosis, Perimeatal, Urethrocutaneous
DOI: 10.7860/JCDR/2025/75919.20714
Date of Submission: Oct 01, 2024
Date of Peer Review: Dec 17, 2024
Date of Acceptance: Jan 16, 2025
Date of Publishing: Mar 01, 2025
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 03, 2024
• Manual Googling: Jan 03, 2025
• iThenticate Software: Jan 14, 2025 (10%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com