Achieving a natural glanular meatus for distal hypospadias with a narrow and shallow plate: Tubularized incised plate versus modified Barcat repair

Abstract

Although the tubularized incised plate (TIP) repair has become the most popular surgical procedure for distal hypospadias, some authors suggest that this is not suitable for hypospadias with a narrow plate or shallow groove. The configuration and position of the reconstructed meatus were postoperatively analyzed in patients with distal hypospadias whose preoperative urethral plates were shallow or narrow. The findings were compared between six patients undergoing TIP repair and seven patients undergoing modified Barcat (BAVIS) repair. Among those undergoing the TIP procedure, a slit-like meatus at the tip of the glans was achieved in one patient, a slit-like meatus at the mid portion of the glans in four patients and a round meatus at the mid portion of the glans in one patient. In those repaired by the BAVIS procedure, a slit-like meatus at the tip of glans was achieved in three patients, a round or irregularly shaped meatus at the tip of the glans in two patients, an irregularly shaped meatus at the mid portion of the glans in one patient and neourethral dehiscence in one patient. The present study confirms that a higher rate of achieving slit-like meatus but a lower rate of locating in the glans tip can be attained after TIP repair. On the other hand, there is a higher rate of locating the meatus in the glans tip but a lower rate of achieving a slit-like meatus after BAVIS repair.