Meatal mobilization (MEMO) technique for distal hypospadias repair: Technique, results and long-term follow-up

Introduction. Several surgical approaches are currently in use for distal hypospadias. Herein, we present our technique of meatal mobilization (MEMO) and provide both early and long-term outcome data. Patients and methods. We investigated 145 patients who underwent repair of distal hypospadias using the MEMO technique. Forty-six patients are short-term (Group A) with a mean follow-up of 28.5 months. Ninety-nine patients (Group B) were available for long-term follow-up (mean 85 months). After penile degloving, mobility of the meatus is evaluated and after urethral preparation the meatus is fixed to the tip of the glans. Glanuloplasty covers the neo-urethra providing a barrier layer. Shaft skin reconstruction completes the procedure. Patients were evaluated regarding operative time, peri- or postoperative complications, hospital stay as well as functional and cosmetic outcome. Results. Mean duration of surgery was 73 minutes. There were no intraoperative complications. There was no repair breakdown, new-onset chordee, or meatal stenosis. Primary success rate was 97% in the shortterm group. In one patient the meatus retracted but remained in the glans. No urethral fistula was seen. During long-term follow-up (group B) one urethral fistula and two meatal retractions occurred that required redo surgery. In one patient a mild ventral penile deviation without a need for correction was noted leaving a success rate of 96%. Conclusions. The MEMO-technique is a valid and reliable method for the correction of distal hypospadias. Complications are minimal while the cosmetic results are excellent. Early success rates exceed 95%. The consistent long-term data prove the durability and effectiveness of this simplified technique.