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EVALUATION OF ONE STAGE MODIFIED MATHIEU’S URETHROPLASTY FOR DISTAL PENILE HYPOSPADIAS IN BIHAR POPULATION

With an incidence of 1:300, hypospadias is one of the most common genital anomalies in male newborns. Hence the present study was planned to evaluate the one stage Flip- flap procedure to repair Distal Penile Hypospadias. Mathieu’s technique (peri-meatal based flap) makes use of the urethral plate in the repair of anterior hypospadias, thereby creating an almost natural neo-urethra. In a circumcised baby or after previous unsuccessful repair, Mathieu’s flap may be one of the few options left to repair anterior hypospadias. 
A total of fourteen patients were included in this study. Their age ranged from 1-13 years, mean age was 4.9 years. Construction of neourethra is generally recommended to be completed before the school going age. The 14 cases of hypospadias are primary repaired by modified Mathieu’s  Flap technique to achieve both cosmetic and functional normality. An overall success rate of 87.5% was achieved and In the remaining 14% of the cases, success was achieved with only one additional procedure. 
The protocol followed the recommended guidelines of surgery. The present study was planned in the Department of Plastic Surgery, Pulse Emergency Hospital, Patna, Bihar. Total surgeries done from Oct 2016 to Nov 2017 were included in the present study. 
The present study concludes that in a developing country like India with rural patients having poor access to good healthcare facilities. One stage Repair is beneficial in many ways. The follow-up compliance of poor rural patients is extremely poor because they need to come to the urban cities for treatment. The authors have seen multiple cases where the patients have gone for the Chordee Correction (first stage of a two-stage repair) in childhood and then reported after a decade. 
Keywords: Hypospadias, MAGPI, Mathieu flap, Single-stage repair, etc.