Modified versus Classical Tubularised Incised Plate Urethroplasty in Hypospadias: A Comparative Study

Area of Science:

• Pediatric Urology
• Surgical Innovation
• Congenital Malformations

Background:

• Hypospadias is a common congenital anomaly affecting 1 in 300 male births.
• Tubularised incised plate (TIP) urethroplasty is a prevalent surgical technique for hypospadias repair.
• Modifications to TIP urethroplasty aim to reduce complications and improve outcomes.

Purpose of the Study:

• To compare the outcomes of standard TIP urethroplasty with a modified technique.
• To evaluate the efficacy of TIP urethroplasty without glans dissection versus complete glans wings mobilization.
• To assess functional results and complication rates of both surgical approaches.

Main Methods:

• A randomized study involving 82 male patients with hypospadias.
• Group A (n=42) underwent TIP with complete glans wings mobilization.
• Group B (n=40) underwent TIP without glans dissection.

Main Results:

• Both techniques demonstrated comparable functional repair rates (88-90%) at 6-month follow-up.
• Common complications included infection, edema, fistulas, and meatal stenosis.
• The modified technique showed significantly lower rates of edema (P=0.04) and need for urethral dilation (P=0.002).

Conclusions:

• TIP urethroplasty without glanular dissection offers comparable functional outcomes to the standard technique.
• The modified approach may reduce specific postoperative complications such as edema and the need for urethral dilation.
• Further evaluation is warranted to confirm the long-term benefits of TIP without glanular dissection.