Study of Hypospadias Repair the Role of Waterproofing Layer by Asopa Single Stage and Snodgrass Technique: A Comparative Analysis

Background: One of the most prevalent congenital genital abnormalities for which early surgery is recommended is hypopadias. The surgical approach is gradually evolving, frequently by reiterating therapy approaches that were employed decades ago. In fact, one-stage operations historically took the role of two-stage procedures, but two-stage procedures are becoming more popular these days. Aim of this study is to the comparative result of hypospadias repair by dividing the patients in two groups Asopa single stage and snodgrass technique and evaluate the complication rates between these two groups especially in reference to incidence of urethrocutaneous fistula. Methods: From March 2025 to August 2025, a prospective study was conducted in the Department of Surgery at the Govt. Medical College and Hospital in Bettiah, West Champaran, Bihar, with 36 cases complaining of hypospadias, or the position of the urethral meatus on the underside of the penis. Result: In the present study, most of our cases (83.33%) were of less than 8 years of age. Most common type was middle hypospadias (50%), followed by proximal (27.77%) and distal (22.22%). Chordee was present in 66.66% of our cases.11.11% cases had penile torsion in pre-operative period. Asopa technique was used in cases with significant chordee and Snodgrass technique used in cases without significant chordee. Urethral plate was well formed and grooved in 66.66% cases, shallow in 27.77% cases and distorted in 5.55% cases. Waterproofing of neourethra was done in 55.55% cases, 44.44% cases were without Water proofing layer. Without Water proofing group had better cosmetic results (87.5%) than with water proofing (70%) but more chances of metal stenosis and skin flap necrosis that leads to urethrocutaneous fistula formation. So Waterproofing decrease the chances of metal stenosis and skin flap necrosis with poor cosmetic results.