Our Summary

This study looked at a surgical operation called the Snodgrass technique, which is used to fix a condition called hypospadias where the opening of the urethra is not at the tip of the penis. The researchers studied 296 patients who had this operation at a hospital in Abbottabad from 2008 to 2021.

They found that the average age of the patients was about 2 years old. The majority of patients had the opening of the urethra near the tip of the penis, while about 20% had it in the middle of the penis. The surgery took about 52 minutes on average.

After the surgery, a small percentage of patients had problems like the new opening of the urethra becoming too narrow (5.1%), a hole forming between the urethra and the skin (7.1%), wound infection (11.8%), and complete disruption (2%).

When looking at how the penis looked after the surgery, 60.1% of patients had a “excellent” or “good” appearance, 30.1% were “acceptable”, and 9.8% were “not acceptable”.

In conclusion, the Snodgrass technique is a good option for fixing hypospadias because it has a low rate of complications and most patients are happy with how their penis looks after the surgery. Key complications include the new opening of the urethra becoming too narrow and a hole forming between the urethra and the skin, but these only happen in a small and acceptable number of patients.

FAQs

  1. What is the Snodgrass technique for hypospadias repair?
  2. What were the most common complications reported in the study of the Snodgrass technique for hypospadias repair?
  3. How satisfactory were the cosmetic outcomes of the Snodgrass technique according to the study?

Doctor’s Tip

A helpful tip a doctor might give a patient about hypospadias repair using the Snodgrass Technique is to follow post-operative care instructions carefully to reduce the risk of complications such as meatal stenosis, urethral-cutaneous fistula, and wound infection. This may include keeping the area clean and dry, avoiding strenuous activities, and attending follow-up appointments as scheduled. Additionally, it is important to communicate any concerns or changes in symptoms to the healthcare provider promptly.

Suitable For

Patients with hypospadias, particularly those with anterior (glanular, coronal, sub coronal) or middle urethral meatal location (distal & mid-shaft), are typically recommended for hypospadias repair using techniques such as the Snodgrass technique. This technique has been shown to have a low complication rate and offer an acceptable cosmetic outcome for patients with a wide range of hypospadias defects. Common complications include urethral-cutaneous fistula and meatal stenosis, but these occur in a low and acceptable number of patients. Overall, hypospadias repair is recommended for patients who are experiencing functional or cosmetic issues due to their hypospadias condition.

Timeline

  • Before hypospadias repair:
  1. Patient is diagnosed with hypospadias, a congenital condition where the urethral opening is located on the underside of the penis.
  2. Patient undergoes pre-operative evaluations and consultations with a pediatric urologist.
  3. Surgical date is scheduled and patient may undergo pre-operative preparation such as fasting and medication adjustments.
  • After hypospadias repair:
  1. Patient undergoes Snodgrass urethroplasty, a surgical technique for hypospadias repair.
  2. Mean operative time is 52 minutes.
  3. Patients may experience complications such as neo-meatal stenosis, urethral cutaneous fistula, wound infection, and complete disruption.
  4. Post-operative care includes monitoring for complications, wound care, and follow-up appointments.
  5. Cosmetic appearance of the penis is assessed post-operatively, with 60.1% of patients having an excellent/good outcome.
  6. Follow-up care may include additional surgical interventions for complications if necessary.

What to Ask Your Doctor

  1. What is the success rate of the Snodgrass Technique for hypospadias repair?
  2. What is the expected recovery time after undergoing the Snodgrass Technique?
  3. What are the potential complications associated with the Snodgrass Technique?
  4. How long will I need to stay in the hospital after the surgery?
  5. Will I need any follow-up appointments or additional procedures after the initial surgery?
  6. What type of anesthesia will be used during the procedure?
  7. How experienced are you with performing the Snodgrass Technique for hypospadias repair?
  8. Are there any specific instructions or restrictions I should follow during the recovery period?
  9. What are the potential long-term effects or outcomes of the Snodgrass Technique for hypospadias repair?
  10. Are there any alternative treatment options available for hypospadias repair?

Reference

Authors: Asad S, Khan FA, Ali S, Khan H, Rafaqat H, Din Khattak IU. Journal: J Ayub Med Coll Abbottabad. 2023 Apr-Jun;35(2):259-264. doi: 10.55519/JAMC-02-11003. PMID: 37422817