The Slit-Like Adjusted Mathieu (SLAM) Technique

The Mathieu technique has withstood the test of time for almost 100 years with a study that reported a success rate of 100% in 204 consecutive patients. The major drawback of the original Mathieu technique is the final appearance of the glans (fist-mouth meatus that is not at the tip of the glans). The slit-like adjusted Mathieu technique (SLAM) avoids this drawback and results in a slit-like meatus at the tip of the glans. It is a reliable technique for correction of all distal and mid-penile hypospadias with persistent good results. The key modifications are: the design of a converging incision at the tip of the glans, V-excision from the tip of the meatal-based flap, and the technique of suturing. Multiple layer closure and careful attention to technical details contributed to 3% complication rate in primary distal hypospadias.