[Tubularized incised plate urethroplasty for hypospadias in children]

To present the experience of hypospadias repair using the tubularized incised plate urethroplasty (Snodgrass procedure).

From May 2001 to November 2004, 82 patients with hypospadias underwent the Snodgrass procedure and the clinical data were analysed retrospectively. The mean age was 5 years (1.5 to 16 years). These cases were divided into: the earlier stage group (34 cases) and the later stage group (48 cases); the proximal group (19 cases) and the distal and middle group (63 cases); the primary operational group (49 cases) and the preoperational group (33 cases).

Fistulas occurred in 12 patients (14.6%), complete glans dehiscence in 1 case. Fistula were as follows: 11 cases in the earlier stage group (32.4%) and 1 case in the later stage group (2.1%); 2 cases in the proximal group (10.5%) and 10 cases in the group of distal and middle group (15.9%); 8 cases in the primary operational group (16.1%) and 4 cases in the preoperational group (12.1%). There was statistically significant difference in the incidence of fistula between the earlier stage group and the later stage group (P < 0.01). There was no statistically significant difference between the proximal group and the distal and middle group, between the primary operational group and the preoperational group (P > 0.05). All patients were followed up more than one month. The neo-meatus was in normal position. The results of penile cosmetic and urethral function were satisfactory. Of these cases, 15 were followed up 1.5-6.0 months. The average flow rate was 7.8 ml/s (6.8-10.5 ml/s). The mean of maximum flow rate was 10. 5 ml/s (8.8-14.5 ml/s).

Excellent neourethral functional and superior cosmetic results with low rate of complication can be gained by using tubularized incised plate urethroplasty for the cases of hypospadias without chordee or with mild chordee. But the preputial flap procedure should be chosen in condition that the hypospadias was association with obvious chordee.