The slit-like adjusted Mathieu technique for distal hypospadias

PurposeThe aims of this study were to describe the slit-like adjusted Mathieu technique (SLAM) for distal and midpenile hypospadias and report the midterm follow-up.Materials and MethodsBetween January 2005 and December 2009, the SLAM technique was performed in 923 patients. The key modification is the design of a converging incision and the technique of suturing. Patient age ranged between 4 months to 30 years (mean, 1.5 years). The records of 872 patients who maintained regular follow-up were reviewed. The technique was performed in all forms of distal hypospadias, regardless of the size of the glans or the degree of glans clefting. Cutaneous chordee was corrected by skin mobilization. Follow-up period ranged from 22 months to 6 years (mean, 38 months). A transurethral catheter was used for 1 to 3 days.Results and ComplicationsSatisfactory results were obtained in 848 patients (97%). Fourteen patients developed fistulae. Four patients developed meatal stenosis. Six patients had wound dehiscence.ConclusionsThe SLAM technique is a reliable technique for correction of distal and midpenile hypospadias with persistent good results. It avoids the drawbacks of the classic Mathieu (a transverse rounded meatus that is not terminal). Multiple-layer closure and careful attention to technical details contributed to a 3% complication rate in primary distal hypospadias.