Mathieu and ‘V’ incision sutured (MAVIS) results in a natural glanular meatus

Background: The Mathieu hypospadias repair for distal hypospadias produces a horizontal bucket handle meatus, which is cosmetically unacceptable. A new surgical technique, the Mathieu and “V” Incision Sutured (MAVIS), is described. Methods: In 52 children, with a mean age of 16.5 months, distal hypospadias was repaired using the vascularized parameatal-based flip flap repair. A “V” incision at the apex of the flap, and suturing of each side of the V to the glans flaps followed by glanuloplasty achieved a natural vertical slit meatus. Results: The mean period of follow-up has been 19.7 months. Fistula occurred in 2 patients (3.9%) and was repaired successfully. Conclusions: This technique of MAVIS provides a cosmetically acceptable natural vertical slit glanular meatus. A generous vascular pedicle on the flap covers the lateral suture lines to prevent fistulas.