Is Megameatus intact prepuce a surgical challenge?
Megameatus intact prepuce variant of hypospadias is relatively uncommon and can pose a surgical challenge as the margins of the urethra can vary from case to case. Using an adapted Mathieu technique, one can improve visualization of the urethra during dissection and also provide healthy vascularized coverage to the reconstructed urethra. Complications are rare and functional outcomes should be, in general, satisfactory.
What is a MIP?
The megameatus intact prepuce (MIP) variant of hypospadias is a rare variant of glanular hypospadias, occurring in approximately 3–6% of all hypospadias repair although its exact incidence is unknown given the fact that a number of patients with MIP may not be identified, come to medical attention or the urethral anomaly is not felt to be clinically significant. In the series presented herein, a retrospective accounting shows that 25 of the 481 hypospadias (5%) carried out over the past 10 years had the diagnosis of MIP. Seven more cases were felt to be mild and asymptomatic. Surgery was not recommended in these cases as they may not be associated with functional issues.
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