A Meta-analysis Of The "Snodgrass" Technique And "Mathieu" Technique For Distal Hypospadias

BackgroundHypospadias is a common condition in the male urinary tract. The DistalHypospadias accounts for the majority of hypospadias in male patients, which aremainly surgically treated by “Snodgrass” or “Mathieu” techniques.Research purposesTo determine if “Snodgrass” versus “Mathieu” is the superior technique for DistalHypospadias treatment.MethodThe present thesis included a comprehensive web-based literature review as wellas studies of hard copy journals and conference proceedings on the effectiveness oftreating Distal Hypospadias by “Snodgrass” versus “Mathieu” tchniques. Thefollowing databases were used: PubMed/of Medline database (1995-2012),OVID(1995-2012), EMBASE(1995-2012), Cochrane library, and the China AcademicJournal (CNKI:1995-2012). The literature was analyzed using a risk of biasassessment tool which is recommended by the Cochrane Collaboration and whichuses RevMan5.1software for Meta-analysis. The outcome measures were theoccurrence rate of post-surgical fistula, meatal stenosis, wound dehiscence and flapnecrosis.ResultSeven scientific journal articles were found to address the study objective. Ingeneral, there were no statistical differences between the “Snodgrass” versus“Mathieu” techniques regarding fistula, wound dehiscence and flap necrosisincidences. However, patients treated with “Snodgrass” versus Mathieu showedhigher occurrences of meatal stenosis. The urethra of Snodgrass patients generally showed a vertical slit=like meatus versus the Mathieu treated patients that have ahorizontal and rounded meatus.ConclusionPatients receiving the Snodgrass versus Mathieu treatment, have the preferredvertical slit-like urethra but show the disadvantage of higher incidences of meatalstenosis.