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An Objective Assessment and Comparison of the Cosmetic Outcome: Parental Perspective after Tubularized Incised Plate
1Pediatric Surgery Unit, Ashish Hospital and Research Centre, Jabalpur, Madhya Pradesh, India.
Insights
Parental satisfaction with hypospadias surgery outcomes was significantly higher when foreskin reconstruction was performed alongside tubularized incised plate urethroplasty (TIPU). This highlights the importance of foreskin reconstruction for achieving normal penile appearance.
Area of Science:
- Pediatric Urology
- Surgical Outcomes
- Cosmetic Surgery
Background:
- Hypospadias repair is a common pediatric urological procedure.
- Cosmetic outcomes significantly impact patient and parental satisfaction.
- The role of foreskin reconstruction in hypospadias surgery requires further evaluation.
Purpose of the Study:
- To evaluate parental satisfaction with the cosmetic results of hypospadias surgery.
- To compare outcomes between tubularized incised plate urethroplasty (TIPU) with foreskin reconstruction versus TIPU with circumcision.
- To assess the impact of surgical technique on overall penile appearance.
Main Methods:
- A prospective study involving 70 male patients aged 2-7 years undergoing hypospadias correction.
- Patients were divided into two groups: TIPU with modified foreskin reconstruction (Group 1) and TIPU with circumcision (Group 2).
- Parental satisfaction was assessed using the Pediatric Penile Perception Score (PPPS).
Main Results:
- No statistically significant differences were observed in parent satisfaction regarding urethral opening, glans shape, penile skin, or length between the groups.
- Parental satisfaction with overall genital appearance was significantly higher in Group 1 (foreskin reconstruction) compared to Group 2 (circumcision) (2.60 ± 0.55 vs. 1.77 ± 0.49, P < 0.00028).
Conclusions:
- Foreskin reconstruction in conjunction with TIPU leads to high parental satisfaction with cosmetic outcomes.
- Foreskin reconstruction is a crucial component for achieving a near-normal penile appearance after hypospadias surgery.
- These findings support the routine use of foreskin reconstruction in hypospadias repair to enhance cosmetic results.
Aim:
We aimed to evaluate the parents' view of the cosmetic outcome after hypospadias surgery.
Materials And Methods:
Between January 2017 and December 2020, 70 patients aged between 2 and 7 years underwent surgical correction of hypospadias. Group 1 had 35 patients (coronal: 6, distal: 19, and mid-penile: 10) assigned for tubularized incised plate urethroplasty (TIPU) with modified foreskin reconstruction. Group 2 had 35 patients (coronal: 4, distal: 22, and mid-penile: 9) assigned for TIPU and circumcision. Parents were assessed with the Pediatric Penile Perception Score (PPPS).
Results:
Parent satisfaction for the position and shape of the urethral opening, shape of the glans, penile skin, and length exhibited no statistically relevant difference between the group. Parent satisfaction with the appearance of the genitals in Group 1 was relatively high 2.60 ± 0.55, as compared to Group 2 1.77 ± 0.49 which is statistically significant (P < 0.00028).
Conclusion:
Our experience shows good early cosmetic results of foreskin reconstruction and high parental satisfaction. Foreskin reconstruction should constitute a key element of the final result to restore a penis with an appearance as normal as possible.
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