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Tubularized incised plate repair: functional outcome after intermediate followup
Hisham M Hammouda1, Alaa El-Ghoneimi, Darius J Bagli
1Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Tubularized incised plate repair for hypospadias shows good functional outcomes in toilet-trained children, with 68.7% achieving normal peak urinary flow rates. Further long-term studies are recommended to confirm these findings.
Area of Science:
- Pediatric Urology
- Surgical Outcomes
- Genitourinary Reconstruction
Background:
- Hypospadias is a common congenital condition requiring surgical correction.
- The tubularized incised plate (TIP) repair is a widely used technique for hypospadias.
- Assessing functional outcomes after TIP repair is crucial for patient well-being.
Purpose of the Study:
- To evaluate the functional voiding outcomes in toilet-trained children after tubularized incised plate (TIP) hypospadias repair.
- To analyze uroflowmetry data (peak flow, voided volume, post-void residual) at intermediate follow-up.
- To determine the success rate of TIP repair in achieving efficient bladder emptying.
Main Methods:
- Retrospective analysis of 48 toilet-trained boys who underwent TIP hypospadias repair.
- Inclusion criteria: uroflow data at least 6 months post-primary or 2 months post-secondary repair.
- Uroflowmetry parameters analyzed and plotted against age-volume dependent nomograms.
Main Results:
- 33 out of 48 patients (68.7%) demonstrated a normal peak flow rate.
- 15 out of 48 patients (31.3%) had a low peak flow rate.
- 46 out of 48 patients had post-void residual urine less than 10% of voided volume, indicating efficient emptying.
Conclusions:
- The tubularized incised plate repair generally leads to efficient voiding without straining or significant post-void residual in most children.
- A majority (68.7%) achieved normal peak flow rates at intermediate follow-up.
- Longer-term follow-up, including puberty, is recommended to fully ascertain the functional durability of the TIP repair.
Purpose:
We describe the functional outcome following tubularized incised plate repair of hypospadias in toilet trained children after an intermediate followup.
Materials And Methods:
Children were included in this study only if they were toilet trained and had flow rate data not less than 6 months after primary tubularized incised plate hypospadias repair or 2 months after any secondary procedure to correct complications. Uroflow data (peak flow, voided volume and post-void residuals) were analyzed and plotted on previously determined age-volume dependent nomograms.
Results:
Of the 48 boys 39 required no secondary procedures, while 9 secondary fistula closures were performed in 2, meatotomy in 2 and dilation in 5. After either primary (26) or secondary (7) procedures 33 of the 48 patients (68.7%) had normal peak flow rate and 15 (31.3%) had low peak flow rate. Of the 48 patients 46 had post-void residual urine less than 10% of voided volume.
Conclusions:
Most children will void efficiently with no straining and no post-void residual (1/2) to 4 years after tubularized incised plate hypospadias repair. Of our patients 68.7% have normal peak flow rate. Intermediate followup of larger series and followup at puberty are recommended to resolve the debate concerning the long-term functional outcome of tubularized incised plate hypospadias repair.