Modified tubularized incised plate urethroplasty
Shivaji Mane1, Jamir Arlikar, Nitin Dhende
1Department of Pediatric Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, India.
Journal of Indian Association of Pediatric Surgeons
|June 27, 2013
Summary
Modified tubularized incised plate urethroplasty with preputioplasty offers a safe and effective surgical option for distal hypospadias, achieving acceptable cosmetic outcomes with a low complication rate.
Area of Science:
- Pediatric Urology
- Surgical Techniques
- Hypospadias Repair
Background:
- Hypospadias is a congenital condition requiring surgical correction.
- The tubularized incised plate (TIP) urethroplasty is a common surgical technique.
- Modifications to existing techniques aim to improve outcomes.
Purpose of the Study:
- To present personal experience with a modified TIP urethroplasty.
- To evaluate the efficacy and safety of this modified technique for distal hypospadias.
- To highlight specific technical modifications and their impact.
Main Methods:
- A single-surgeon series of 100 distal hypospadias patients (age 1-5 years) underwent modified Snodgrass urethroplasty with preputioplasty.
- Inclusion criteria: good urethral plate, no chordee/torsion.
- Modifications included spongioplasty, preputioplasty, and dorsal slit if needed.
Main Results:
- Average follow-up was 23 months.
- Complications included fistula (7%), preputial dehiscence (1%), and phimosis (3%).
- Most patients achieved a single urinary stream and acceptable cosmetic results; 7 required dorsal slit.
Conclusions:
- Modified TIP urethroplasty with preputioplasty is effective for distal hypospadias.
- The technique yields cosmetically satisfactory results.
- Complication rates are considered low with this modified approach.
