Efficacy of modified tubularized incised plate urethroplasty for hypospadias
Nuoxian Li1, Shengli Zhang2, Luping Li1
1Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Insights
Modified tubularized incised plate urethroplasty (TIPU) improved penile appearance and urinary flow in pediatric hypospadias repair. This technique showed no increase in complications compared to conventional TIPU.
Area of Science:
- Pediatric Urology
- Surgical Innovation
- Hypospadias Repair
Background:
- Hypospadias is a common congenital condition requiring surgical correction.
- Tubularized incised plate urethroplasty (TIPU) is a widely used technique for hypospadias repair.
- Optimizing cosmetic and functional outcomes remains a key goal in hypospadias surgery.
Purpose of the Study:
- To evaluate the clinical outcomes of a modified TIPU (mTIPU) technique.
- The mTIPU involves urethral plate dissection and distal urethral mobilization.
- To compare mTIPU with conventional TIPU (cTIPU) in children with mid-to-distal hypospadias.
Main Methods:
- Retrospective study of 183 pediatric patients undergoing primary hypospadias repair.
- Patients were divided into mTIPU (n=86) and cTIPU (n=97) groups.
- Comparison of baseline characteristics, perioperative data, complications, penile appearance, and uroflowmetry.
Main Results:
- The mTIPU group had longer operative times and greater estimated blood loss.
- No significant difference in overall postoperative complication rates between groups.
- mTIPU resulted in superior penile appearance scores and improved urinary flow parameters (Qmax, Qave, shorter voiding duration) at 2-year follow-up.
Conclusions:
- Modified TIPU with urethral plate dissection and mobilization offers potential benefits for hypospadias repair.
- Improved cosmetic and functional outcomes were observed with mTIPU.
- The modified technique does not increase the risk of postoperative complications.
Purpose:
To evaluate the clinical outcomes of tubularized incised plate urethroplasty (TIPU) combined with dissection of the urethral plate and distal urethral mobilization in children with mid-to-distal hypospadias.
Methods:
This retrospective study included 183 pediatric patients with hypospadias who underwent primary repair between March 2021 and March 2023. Patients were divided into two groups according to the surgical technique: the modified TIPU group (mTIPU, n = 86) and the conventional TIPU group (cTIPU, n = 97). Baseline characteristics, perioperative parameters, postoperative complications, penile appearance scores, and uroflowmetry parameters were compared between the two groups.
Results:
Baseline characteristics were comparable between the two groups (all P > 0.05). The mTIPU group had a longer operative time and a greater estimated blood loss (EBL) than the cTIPU group (both P < 0.05). However, no statistical difference was observed in the overall incidence of postoperative complications between the groups (P > 0.05). At the 2-year follow-up, patients in the mTIPU group demonstrated higher penile appearance scores for perceived penile straightness and overall appearance (both P < 0.05). In addition, the maximum urinary flow rate (Qmax) and the average urinary flow rate (Qave) were higher, and the duration of micturition was shorter in the mTIPU group compared to the cTIPU group (all P < 0.001), while voided volume did not differ significantly between the two groups (P > 0.05).
Conclusion:
In children with mid-to-distal hypospadias, TIPU combined with urethral plate dissection and distal urethral mobilization may improve postoperative penile appearance and urinary flow parameters. No statistical difference in postoperative complication rates was observed between the two techniques.
