Snodgrass Versus Grafted Snodgrass Repair in Narrow Urethral Plate in Distal Penile Hypospadias

Not Applicable

Recruiting

• Conditions: Hypospadias
• Interventions: Procedure: Snodgrass repair; Procedure: Snodgrass repair with graft

• Registration Number: NCT06405763
• Lead Sponsor: Sohag University

Brief Summary

We aime to compare between Snodgrass and grafted Snodgrass repair in the outcome in distal penile hypospadias with urethral plate less than 8mm

Detailed Description

The main goal for hypospadias repair is to achieve both cosmetic and functional normality.

Several surgical techniques for hypospadias repair have been developed that depend on the site of the urethral meatus in children The effect of the urethral plate characteristics on the surgical outcome of Snodgrass repair has been studied in many series. Some documented that urethral plate width has a significant impact on the complication rates Holland and Smith reported a high complication rate in Snodgrass repair with a urethral plate width of less than 8 mm 7 The augmentation of the urethral plate either with inlay graft (DIGU, Snodgraft, or G-TIP), Onlay preputial flap, or other flaps carries a better outcome than the original TIP in many studies Others denied any effect of the narrow urethral plate on the success rate We aim in this study to determine which is better in narrow urethral plate in distal penile hypospadias, as regarding surgical and cosmetic outcomes; Snodgrass or combined inner preputial graft with Snodgrass

Study Timeline

• Study Start: 2023-12-11
• Study First Submitted: 2024-04-28
• Status Verified: 2024-05
• Study First Submitted QC: 2024-05-03
• Last Update Submitted: 2024-05-03
• Study First Posted: 2024-05-08
• Last Update Posted: 2024-05-08
• Primary Completion: 2024-12-10
• Study Completion: 2024-12-10

Recruitment & Eligibility

• Status: RECRUITING
• Sex: Male
• Target Recruitment: 50

Inclusion Criteria

Children age: > 6m up to 16y

• Distal penile hypospadias(distal shaft,coronal,subcoronal )
• mid penile hypospadias with mild chordae les 30 degree
• Urethral plate <8 mm in maximum transverse diameter before the midline urethral plate incision .Primary non-circumcised cases of hypospadias

Exclusion Criteria

• Proximal and mid penile hypospadias with marked chordae
• previous hypospadias repair

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Snodgrass repair group	Snodgrass repair	A relaxing incision is made in the midline by using scalpel or scissors from Within the meatus to the end of the plate. A 6 F stent is passed into the bladder. The neourethra is closed using a fine suture, 7-0 or 6-0 vicryl sutures in two-layer.
Snodgrass repair with graft group	Snodgrass repair with graft	A relaxing incision is made in the midline by using scalpel or scissors A free graft was measured and harvested from the inner prepuce and was defatted and sutured onto the incised urethral plate after the urethral plate was incised he graft was sutured overlying the incision line A 6 F stent is passed into the bladder. The neourethra is closed

Primary Outcome Measures

Name	Time	Method
Functional outcome	12 months	Investigators want to compare between Snodgrass and combined inner preputial graft with Snodgrass in functional outcome by evaluation of the stream an ideal stream of urine (single, compact, rifled, non-dispersed urinary stream of adequate caliber) without straining.
Cosmetic outcome	12 months	Investigators want to compare between Snodgrass and combined inner preputial graft with Snodgrass in cosmetic outcome By Hypospadias Objective penile Evaluation (HOPE) Score 1.meatus position 2.meatus shape 3.glans shape 4.penile skin shape 5.penile axis secreal 6.Torsion

Trial Locations

Locations (1)

Sohag University Hospitals; 🇪🇬 Sohag, Egypt