Modified tubularized incised plate urethroplasty (Snodgrass) procedure for hypospadias repair
Angelo A Baccala1, Jonathan Ross, Nicholas Detore
1Department of Pediatric Urology, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. baccala@ccf.org
Objectives:
To report the outcomes in a large series using a modified tubularized incised plate (TIP) urethroplasty (Snodgrass) technique with a local de-epithelialized skin flap to cover the urethroplasty. The use of the TIP urethroplasty (Snodgrass) technique has gained wide acceptance among pediatric urologists for the correction of hypospadias repair because of its good cosmesis, low complication rate, and reliability in creating a vertically oriented meatus.
Methods:
A total of 101 boys, aged 6 months to 3 years, with distal (n = 85), mid-shaft (n = 8), or proximal (n = 8) hypospadias underwent one-stage repair using a modified TIP repair with a local de-epithelialized skin flap to cover the urethroplasty. Charts were reviewed for each patient to determine the complications, reoperations, cosmesis, and functional results after surgery.
Results:
With at least 6 months of follow-up, all patients had achieved excellent functional and cosmetic results, with the meatus at the tip of the penis on follow-up. Three repairs for meatal stenosis and two for fistula were needed.
Conclusions:
The modified TIP procedure is a safe and reliable technique. It provides excellent cosmesis with a low reoperation rate.
