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Tubularized incised-plate urethroplasty for distal and proximal hypospadias
1Department of Paediatric Urology, Great Ormond Street Hospital for Children NHS Trust, Guy's Hospital, and Institute of Child Health, London, UK. madsammuohya@aol.com
Insights
Tubularized incised-plate (TIP) urethroplasty is an effective surgical technique for hypospadias repair in boys, offering good cosmetic outcomes and a low complication rate. This method maximizes the use of the urethral plate for successful reconstruction.
Area of Science:
- Pediatric Urology
- Surgical Reconstruction
- Congenital Anomalies
Background:
- Hypospadias is a common congenital condition affecting the male urethra.
- Surgical repair aims to correct the anatomical defect and ensure normal voiding and sexual function.
- The tubularized incised-plate (TIP) urethroplasty is a widely used technique for hypospadias repair.
Purpose of the Study:
- To describe the outcomes of tubularized incised-plate (TIP) urethroplasty for distal and proximal hypospadias.
- To evaluate the complication rates and functional results of the TIP technique in primary hypospadias repair.
Main Methods:
- A consecutive series of 83 boys underwent TIP urethroplasty for primary hypospadias repair.
- Patients included those with distal (78%) and proximal (22%) penile hypospadias.
- Follow-up assessments included early (7 days) and late (median 4 months) evaluations.
Main Results:
- The overall late complication rate was 12%, with 10% requiring secondary surgery.
- Urethrocutaneous fistula occurred in 5% of distal and 5.6% of proximal hypospadias cases.
- Glans dehiscence occurred in 1% of distal hypospadias cases. All secondary repairs were successful, with all children voiding normally.
Conclusions:
- TIP urethroplasty is a versatile and simple surgical procedure for hypospadias.
- The technique yields good cosmetic results and effectively utilizes the urethral plate.
- It is a reliable option for both distal and proximal hypospadias repair.
Objective:
To describe the tubularized incised-plate (TIP) urethroplasty for distal and proximal hypospadias.
Patients And Methods:
TIP urethroplasty was undertaken in 83 consecutive boys (mean age 14.1 months, sd 7.8) within the past 3 years; 65 (78%) had distal and 18 (22%) proximal penile hypospadias. This was the primary attempt at hypospadias repair in all children.
Results:
All patients were assessed 7 days after surgery at the time of dressing and catheter removal, and subsequently at a median of 4 months in the clinic, before being discharged. The overall late complication rate was 12% and 10% required a second operation. There was a urethrocutaneous fistula in three (5%) of those with distal and in one of the 18 with proximal penile hypospadias (P = 0.56). Glans dehiscence in distal hypospadias occurred in one (1%) and three, respectively (P = 0.01). Secondary surgery for fistula repair and glans closure was successful in all patients. All children void with a single straight urinary stream in a forward direction, and have a normally situated vertical slit-like glanular meatus.
Conclusions:
TIP urethroplasty is a versatile, simple operation with good cosmetic results, which uses the urethral plate to its maximum potential.
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