Outcomes of Repair of Anterior Penile Hypospadias by Snodgrass Technique: A Study of 50 Cases


Anterior penile
Urethral meatus


How to Cite

Huda S, Uddin Khan UK, Hasina K, Al-Miraj AK, Ahmed F, Bose GK. Outcomes of Repair of Anterior Penile Hypospadias by Snodgrass Technique: A Study of 50 Cases. Integr J Med Sci [Internet]. 2022 Apr. 11 [cited 2023 Sep. 22];9. Available from: https://mbmj.org/index.php/ijms/article/view/659


Introduction: Hypospadias is a developmental anomaly characterized by a urethral meatus that opens onto the ventral surface of the penis proximal to the end of the glans. Hypospadias occurs in 1 in 125 live male births. Classically, three abnormalities are found in the hypospadias penis: (1) an ectopic opening of the urethral meatus at the ventral surface; (2) a ventral curvature of the penis (chordee); (3) a hooded foreskin on the dorsum of the penis with a lack of skin on the ventral due to a V-shaped defect referred to as urethral delta. There are anterior (65%), middle (15%), and posterior penile hypospadias (20%). Objective: The objective of surgical repair of hypospadias is to provide complete straightening of the penis, placing the meatus at the tip of the glans, forming a symmetrical conical-shaped glans, and constructing a neo-urethra uniform in caliver and acceptable skin coverage. Materials and Methods: This is a cross-sectional, descriptive, observational study conducted in the Department of Pediatric Surgery, Dhaka Medical College & Hospital, Dhaka, Bangladesh, from 1 January 2009 to 30 June 2010. The total number of cases is 50. Patients having anterior penile hypospadias were selected by simple random sampling. The mean age of the patients was 5.22 years (2 to 10 years). Surgical correction was done using the Snodgrass technique. The mean operative time was 90 minutes and the postoperative hospital stay was 10 days. Results: Satisfactory results were obtained in 35 (70%) patients, and only 14 (28%) had urethrocutaneous fistula, wound infection was developed in 5 (10%) patients, and two (4%) patients had meatal stenosis. The outcome was evaluated based on urethrocutaneous fistula, meatal stenosis, and cosmesis. Of 50 patients, 35 (70%) had no urethrocutaneous fistula and the results were cosmetically acceptable. Conclusion: Early detection and correction are essential to minimize the complications and lessen the psychological trauma of the patient. Therefore, a thorough examination of the neonates following delivery in different maternal and child care clinics is mandatory. Early and timely measures also give the best cosmetic and functional results. Thus, we should put all our efforts into achieving this goal.



Mouriquand PDE, Mure PY. Hypospadias in gearhart. J P. 2004:215-218.

Sadler TW. Langmans Medical Embryology. 5" Bd. Baltimore: Williams and Wilkins. 1985:109.

Svensson J, Berg R, Berg G. Operated Hypospadias, Late follow up. Social Sexualad Psychological adaptation. J Pediatr Surg. 1981 Apr;16(2):134-5. https://doi.org/10.1016/s0022-3468(81)80338-7

Baskin LS. Hypospadias, Pediatric surgery, 6th edition. 2006 ;1870-1898.

Duckett JW. Baskin LS. Hypospadias Jn; O Neill JA, Rowe ML. Grosfeld J. L Fankalsrud, E. W. Coram, A.G. (Eds). Pediatric urology, vol. 2, 5th ed. Mosby year- bookco, St. Louis. 1998; 1761-82.

Spitz L, Coran AG. Rob & Smith's Operative Pediatric Surgery, 6th edition 2006:842.

Murphy I. Ilyopspacias to Asheran, KW Sharp Siglet, DL Snyder L. (eds) Pediatrie Surgery. 3rd. 2000; 761782

Snodgrass W. Tubularized incised plate urethroplasty for distal hypospadias. J Urol. 1994 Feb;151(2):464-5. https://doi.org/10.1016/s0022-5347(17)34991-1

Snodgrass W, Koyle M, Manzoni G, Hurwitz R, Caldamone A, Ehrlich R. Tubularized incised plate hypospadias repair,Results of a multicenter experience. J Urol. 1996 Aug;156(2 Pt 2):839-41. https://doi.org/10.1097/00005392-199608001-00082

Rickwood AM, Anderson PA. One stage Hypospadias relair.Experience in 367 cases. Br J Urol. 1991 Apr;67(4):424-8. https://doi.org/10.1111/j.1464-410x.1991.tb15171.x

Retik AB, Keating M, Mandell J. Complication of hypospadias repair. Urol Clin North Am. 1988 May;15(2):223-36.

Islam MM. Comparison of the outcome between Tubularizedincis plate urethroplasty(Snodgrass) and Urethral plate augmentation (Snod-graft) in distal hypospadi

Salim S, Rich MR, Charlot S, Brinchmann J, Johnson BD, Schiminovich D, et al. UV star formation rates in the local universe. Astrophysi J. 2007;173(2): 267. [Accessed 2022 Apr 11]. Available from: https://iopscience.iop.org/article/10.1086/519218/meta

Gunter JB, Forestner JE, Manley CB. Caudal epidural anaesthesia reduces blood loss during hypospadias repair. J Urol. 1990 Aug;144(2 Pt 2):517-9; discussion 530.

Alam MS. Comparison of single stage correction of distal and midpenile Hypospadias by V.T Josephs technique and onlay island flap technique (Thesis). BSMMU; 2000: 50-67.

Sajid MM, Karim S. Comparison between the outcome of tunica vaginalis blanket wrap and nonwrap procedure in urethroplasty. J Paediatr Surg Bangl. 2012; 3(1). https://doi.org/10.3329/jpsb.v3i1.23904

Baskin LS, Duckett JW. Buccal mucosal graft in hypospadias surgery. Br J Urol. 1995 Dec;76 Suppl 3:23-30. https://doi.org/10.1111/j.1464-410x.1995.tb07814.x

Haque SA, Palomares E, Cho BM, Green AN, Hirata N, Klug DR, et al. Charge separation versus recombination in dye-sensitized nanocrystalline solar cells: the minimization of kinetic redundancy. J Am Chem Soc. 2005 Mar 16;127(10):3456-62. https://doi.org/10.1021/ja0460357

Montagnino BA, Gonzales ET Jr, Roth DR. Open catheter drainage after urethral surgery. J Urol. 1988 Nov;140(5 Pt 2):1250-2.https://doi.org/10.1016/s0022-5347(17)42016-7

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2021 S.M Samsul Huda, Md. Arif Uddin Khan, Kaniz Hasina, A. K. Al-Miraj, Farid Ahmed, Gouranga Kumar Bose


Download data is not yet available.


Metrics Loading ...