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Updated: Jun 22, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Effect of suturing technique and urethral plate characteristics on complication rate following hypospadias repair: a
Osama Sarhan1, Mohamed Saad, Tamer Helmy
1Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt. o_sarhan2004@yahoo.com
Insights
For tubularized incised plate urethroplasty, suture technique does not impact outcomes. However, adequate urethral plate width (≥8 mm) is crucial for successful hypospadias repair.
Area of Science:
- Urology
- Pediatric Surgery
Background:
- Hypospadias repair is a common pediatric urological procedure.
- Tubularized incised plate urethroplasty is a widely used technique for hypospadias correction.
- Complication rates following urethroplasty can impact functional and cosmetic outcomes.
Purpose of the Study:
- To investigate the influence of suturing technique on complication rates in tubularized incised plate urethroplasty.
- To assess the impact of urethral plate characteristics on the success of hypospadias repair.
- To identify predictive factors for complications after tubularized incised plate urethroplasty.
Main Methods:
- A prospective, randomized study of 80 boys with primary hypospadias.
- Patients were allocated to continuous or interrupted suture groups.
- Urethral plate dimensions (depth, length, width) were measured before and after incision.
Main Results:
- Overall complication rate was 13.8%, including fistula, dehiscence, and meatal stenosis.
- Success rates varied by hypospadias location (90% anterior, 69% mid-penile).
- Urethral plate width before incision was significantly associated with complication occurrence (p=0.048).
Conclusions:
- Suture technique does not influence the outcome of tubularized incised plate urethroplasty.
- Urethral plate width is a critical factor in successful urethroplasty.
- Ensuring adequate urethral plate width (≥8 mm) is essential for minimizing complications and achieving successful hypospadias repair.
Purpose:
We studied the effect of suturing technique and the impact of urethral plate characteristics on the complication rate following tubularized incised plate urethroplasty.
Materials And Methods:
We prospectively studied 80 boys (mean age 4.5 years, range 3 to 7) with primary hypospadias in a randomized fashion between January 2004 and May 2005. Of the patients 64 had anterior and 16 had mid penile hypospadias. Patients were allocated into 2 groups according to suture technique, with continuous sutures used in 40 boys and interrupted sutures in 40. We evaluated urethral plate depth, length and width before and after incision. Correlation between suture technique, plate type, width and length, and complication rate was performed.
Results:
Mean followup was 3 years. Success rates were 90% and 69% for anterior and mid penile hypospadias, respectively (p = 0.037). Complications developed in 11 patients (13.8%) and consisted of fistula (8), dehiscence (2) and meatal stenosis (3). On univariate analysis the suture technique, depth and length of urethral plate, width after incision and presence of hypoplasia had no impact on complication occurrence. However, urethral plate width before incision was significantly related to complication occurrence (p = 0.048).
Conclusions:
Suture technique has no influence on the outcome of tubularized incised plate urethroplasty. Urethral plate characteristics do not affect the complication rate except for plate width, which significantly affects the outcome. Adequate urethral plate width (8 mm or greater) is essential for successful tubularized incised plate repair.
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