Mathieu vs urethral plate tubularization in circumcised Megameatus intact prepuce repair: A prospective randomized comparative study.

Abstract

The objective of this study is to evaluate and compare urethral plate tubularization vs Mathieu in circumcised Megameatus intact prepuce (MIP) repair. Many techniques were described for MIP, which account for 5% of hypospadias cases and usually diagnosed at time of, or even after circumcision. Forty-six circumcised MIP cases were prospectively enrolled in this prospective study, which was carried out in April 2017 and March 2020. Patients were randomly allocated into two groups. Group one operated by simple urethral plate tubularization and group two by the Mathieu technique. Hypospadias objective scoring evaluation (HOSE) scores, success rate, operative time, and the need for relaxing incision or scrotal flaps for skin closure were compared. Forty-three circumcised cases (22 in group one and 21 in group two) completed at least 6 months of follow-up. Ages ranged from 12 to 39 months (mean 18.06 6 6.35) in group one and from 10 to 32 months (mean 19.5 6 7.14) in group two. There was no significant difference between cases with accepted outcome based on HOSE scores (14) of the two groups (P value ¼ .942). Three fistulae and one meatal stenosis were the complications in group one (18.2%). In group two, two patients complicated with fistula (9.5%) (P value ¼ .674). Significant differences were present only in the operative time (P ¼ .001) and in the need of relaxing incision or scrotal skin flaps (P ¼ .012) both were more in group two. Mathieu and tubularized incised plate urethroplasty both are good options for circumcised MIP repair.