Tubularized incised plate urethroplasty of hypospadias
Anwar-ul-Haq1, Ilyas Bader, Nadeem Akhter
1Department of Pediatric Surgery, The Children Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan. drahaq@hotmail.com
Objective:
To describe tubularized incised plate (TIP) urethroplasty, for the treatment of anterior hypospadias.
Design:
Descriptive study.
Place And Duration Of Study:
This study was carried out in the Department of Pediatric Surgery, The Children hospital, Pakistan Institute of Medical Sciences Islamabad, from January 2003 to February 2004.
Materials And Methods:
There were 30 patients with anterior hypospadias. Children between 2-years to 12 years were included in the study. Tubularized incised plate urethroplasty (Snodgrass procedure) was performed in all the patients. Meatus was matured taking care not to close too much to avoid stenosis. Dressing was kept to prevent haematoma and oedema formation. Frequent irrigation of the stent was done to avoid blockage.
Results:
Procedure was successful in 22 patients. Meatal stenosis was noted in three patients, two required dilatations only and in one patient meatotomy was performed. Three patients developed single urethrocutaneous fistula. One patient had complete breakdown.
Conclusion:
Tubularized incised plate urethroplasty was found to be a useful procedure for distal or anterior hypospadias with less complications. Special precautions like maturing the meatus to avoid stenosis and keeping the stent patent with frequent irrigation helps in minimizing fistula formation. The dressing technique prevented postoperative haematoma and oedema of penile stuff.
