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Outcomes of Snodgrass (TIP) versus Slit Like Adjusted Mathieu (SLAM) in distal penile hypospadias repair in pediatrics

Background: Hypospadias is the most common anomaly in male genital tract. Both Snodgrass tubularized incised plate (TIP) and Mathieu repair are widely accepted for treatment of distal hypospadias. The study aimed to compare outcomes of TIP versus SLAM for treatment of primary hypospadias in pediatrics. Methods: A prospective study was performed including 50 cases with distal primary penile hypospadias undergoing TIP from January 2020 to January 2022, at Minia University Hospital, Egypt. The cases were divided into two groups of equal number. In group I, 25 cases underwent TIP. In group II, 25 cases underwent SLAM. The assessed parameters were postoperative bleeding, edema, infection, fistula formation, meatal stenosis, stricture of the urethra, complete disruption of the repair, and cosmosis. Results: There was a significant less operative time in group I (65.64 minutes ± 8.76 versus 94.46 minutes ± 7.44, P < 0.0001). There were no significant differences in incidence of postoperative bleeding, edema, infection, incidence of urethrocutaneous fistula 8% in both groups, there was significant difference in incidence of meatal stenosis (16% and 0% respectively), P 0.037. Conclusion: Both TIP and SLAM repair had good outcome and minimal complication rate. Both are safe, reliable and reproducible techniques in distal hypospadias repair.