Outcome of glandular urethral Disassembly (GUD) Technique in Distal penile hypospadias Repair

Abstract Introduction Different surgical techniques have been described for repair of DPH included MAGPI, TIP, MATIU, GUD TIP is the most commonly performed surgery for hypospadias, and the most common complications are urethrocutaneous fistula, meatal stenosis, especially if the glans width 14 mm and urethral plate <6mm The technique of urethral mobilisation was first described by Beck (1898) and was popularized by Koff in 1981 . The main advantage of the this procedure is the absence of urethroplasty and, consequently, a low risk of fistula . but the distance prone for mobilisation is up to 1.5 cm, all of the previous techniques focusing on urethral mobilisation only and the distance between the urethral opening and the tip of the glans ,but in GUD technique focusing on minimal urethral mobilisation and extensive glandular dissection like we do in epispedias repair Aim of the study to present the results of GUD technique for different types of distal penile hypospadias . Patients and methods This study was conducted at Zagazig University Hospitals from April 2021 to April 2023 , include 30 patients underwent repair of Distal penile hypospadias by GUD technique Inclusion criteria Primary cases of DPH recurrent distal hypospadias or urethral fistula cases Exclusion criteria presence of severe chordee, Mid penile hypospadias a proximal hypospadias and Results This study include 30 patients , 5 patients (16.6%) presented with a complication after the procedure as follows: 2 cases (6.6%) with meatal stenosis., 1 dehiscence that was predisposed by infection meatal retraction in 1 (3.3%) One patient (3.3%) presented with a fistula that may be caused by accidentally injury of the urethra No post operative Bleeding ,infection, iatrogenic chordee 10 (33.3%) of cases were coronal type , 7(23.3% )recurrent DPH ,6( 20% )subcoronal,3(10%) glandular, 2(6.6% ) urethral fistula 2 (6.6%) megameatus intact prepuce. The mean age at surgery was 2.7year, mean operative time was 38.1 minutes, mean Hospital stay 12.8h , mean duration for catheter removal 4.6 days and the follow up duration was 3.6 months. Conclusion GUD procedure is a is a simple , safe technique for distal penile hypospedias in selected cases with minimal complication