Lessons learnt from Snodgrass tip urethroplasty: a study of 75 cases

Introduction and objectives. Snodgrass tubularized incised plate urethroplasty and 2 modifications were evaluated in 75 hypospadiacs (distal and midpenile). Patients and methods. The initial 25 patients (group A), underwent Snodgrass tubularized incised plate urethroplasty. In the next 25 patients (group B), the urethral plate defining incision and Snodgrass urethrotomy were not extended distally to the glans tip and the neourethra was reconstructed (distal to proximal) over a spacer. In the last 25 patients (group C), dorsal free skin grafting of the raw area (following Snodgrass urethrotomy) was done. Results. In group A, all patients developed meatal stenosis and required intermittent dilatation for 3 months. In groups B and C meatal stenosis did not occur. Conclusions. Restriction or elimination of the raw area in the region of the neomeatus as in groups B and C effectively prevents meatal stenosis following Snodgrass repair.