الفهرس 
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Abstract
Hypospadias is one of the most common anomalies of the external genitalia .
Hypospadias is a congenital abnormality caused by incomplete development of urinary meatus, in which the meatus is opened on the ventral side of penis instead of apex of glans .
It occurs as a result of abnormal urethral closure at around 8 to 14 weeks after conception. A variety of mechanisms involving exposures to endocrine disruptors and genetic impairment have been proposed to cause hypospadias.
Hypospadias is divided into three types ”posterior, middle, and anterior” regarding the position of meatus. Anterior hypospadias constitutes 71%, middle 16%, and posterior 13% .
In anterior type, meatal orifice opens either on distal penile shaft, on corona, or under the glans . Anterior hypospadias is the most common form.
The incidence of hypospadias has been calculated to be 3.2 in 1000 live male births, or approximately 1 in every 300 male .
The anatomy of the hypospadiac penis is similar to the normal penis except on the ventral aspect where the abortive foreskin and arrested urethra and urethral spongiosum are deficient.
Surgical repair is the only possible means of treatment for hypospadias.
Optimal age for hypospadias repair is between 8 and 12 months of age. At that stage, the size of the penis is almost equivalent to that of a 3
year old child, and the trophic conditions of the skin allow a high degree of safety during operation . Children at that age suffer much less emotionally during the postoperative period than do older children and, as a consequence, parents’ anxiety is also alleviated .
Although there are 300 operations described in the literature for repair of hypospadias, there is no standardized technique with confirmed satisfactory results .
The ultimate goal of hypospadias surgery is to create a normal looking penis with a terminally situated conical meatus, to correct chordee if present and to ensure a well-directed, straight, and full urinary stream in the standing position.
Complications of hypospadias repair include Bleeding , hematoma, meatal stenosis, urethrocutaneous fistula, urethral stricture, urethral diverticulum, wound infection, impaired healing, and breakdown of the repair .
Our study aimed to compare between two techniques for hypospadias repair which are perimeatal based flap technique (Mathieu) and tubularized incised plate (Snodgrass) .
Each technique was applied at the same number of patients in two groups as follow :
a. Snodgrass group: this includes 15 patients subjected to tubularized incised plate (Snodgrass) technique .
b. Mathieu group : that also includes ten patients subjected to permeatal based flap (Mathieu) technique .
Both techniques were applied at the two groups in the period between )2011 – 2014(.
Follow up of the patients ranged from one week to six months thorough observation showed that :
In Snodgrass group: 4 cases (26.7%) developed urethrocutaneous fistula two of them repaired later on .
In Mathieu group: 5 cases (33.3%) developed urethrocutaneous fistula 4 of them were repaired later on, other one healed spontaneously.
On comparing the two groups, the first group achieved better results as regard the incidence of post operative severe edema which occurred in one patient of Snodgrass group (6.7%) compared with 3 patients of Mathieu group (20%), and the shape of external meatus: In 12 cases of Snodgrass it was vertical ,while 3 cases was rounded. Compared with 10 cases of Matheiu group the shape of external meatus was transverse and it was rounded in 5 cases. Statistical analysis show that there is highly statistically significant difference between them (P-value ≤ 0.001).
Regarding other post operative complications. there is no statistically significant difference between both techniques (P value > 0.05