Surgical Options in the Management of Megameatus Intact Prepuce.

What is it about?

Introduction: Surgical options in the management of megameatus intact prepuce depends on various scenarios and its multifactorial hence the different surgical options with different outcomes, Hypospadias is a spectrum of different variants and megameatus intact prepuce (MIP) is a rare variant of glandular hypospadias seen is about 3-6% of cases of hypospadias. Materials and Methods: We search the following sites Google Scholar, PubMed Central (PMC), PubMed, AJOL and EMBASE for articles on Megameatus intact prepuce, and the last search was on 21st July, 2019, using the keywords surgical management options of megameatus intact prepuce and the relevant articles were reviewed to extract the surgical options of managing megameatus intact prepuce variant of hypospadias from the experts. Results: The Surgical Management of MIP is aimed at restoring function and cosmesis and several surgical techniques were described, including the glanular approximation procedure (GAP), the pyramid procedure, cutaneous advancement procedure, Tubularised incised plate (TIP), Tubularised Urethral Plate Urethroplasty (TUPU), Mathieu technique, and the subcutaneous frenulum flap with many modifications. Discussion: MIP is rare and was first described by Juskiewenski and co in 1983, so many researchers reported various surgical options of treatment reporting different outcomes, in 2011 Elbatarny et al described GAP in seventeen patients with MIP over a period of 5years with an excellent outcome in 14 patients and 2 patients had a subjective score of 1 while one patient expressed dissatisfaction with the outcome, M. Sanal et al reported an excellent outcome in 7 cases with GAP. Conclusion: The surgical management of options of megameatus intact prepuce are many with various modifications and outcomes and hence the need for a urologist to get acquainted with as many techniques as possible so as to achieve a desired goal in managing this category of patients with rare anomaly.

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Why is it important?

It discussed the details of the surgical procedures for Megameatus Intact Prepuce variant of Hypospadias.