Primary anterior hypospadias repair: a review of clinical outcomes

Abstract

Hypospadias is a common congenital urogenital deformation. Its most frequent form is anterior hypospadias, where the urethral meatus was located at the glans (glandular), just below the glans (sub-coronal), or on the distal shaft. Various surgical procedures can be performed to correct anterior hypospadias. The most common used procedures are meatal advancement and glanduloplasty incorporated (MAGPI), tubularized incised plate (TIP), and Mathieu repair procedures. Choosing which procedure to date there are no guidelines on determining which procedure to perform or which will produce the best results. We conducted a review to compare the outcomes of each procedure, considering cosmetic and functional aspects, as well as risks of complications. The results showed lack of evidences that perform direct comparison among the different outcomes; therefore, we have to rely on observational and descriptive sources. However, available evidence painted a picture of somewhat comparable outcomes on all aspects between the three procedures for anterior hypospadias. The underlying theme was the importance of selecting the appropriate procedure for each patient, considering each patient’s unique anatomical presentation for the best cosmetic outcome, as well as the skill and confidence of each surgeon.