Analysis of Five-year Experience with Tubularized Incised Plate Urethroplasty for Anterior and Mid Penile Hypospadias

Abstract

Aim of the study was to evaluate the results of tubularized incised plate (TIP) urethroplasty in distal and mid penile hypospadias repair. In this retrospective study, we analyzed the medical records of 195 boys (mean age: 2.1 years, range: 0.5-13 years) with distal penile (n=170) or mid penile hypospadias (n=25), who underwent TIP urethroplasty between January 2003 and December 2007 in our institution. The details of the procedure are described and the postoperative outcomes and treatment of complications are reviewed. Patients were followed up for a mean of 36 months (range: 6-60). Mean duration of surgery was 57.9 (range: 40-100) minutes. Mean duration of postoperative hospital stay was 10.5 (range: 7-12) days. The overall complication rate was 16.9 % with 12.6% patients requiring specific intervention. The overall rate of fistula occurrence was 7.2%; the incidence of meatal stenosis was 5.6% and of wound dehiscence was 2.7%. The difference between the incidence of complications after repair of mid or distal penile hypospadias was found to be statistically insignificant (p<0.05). Our complication rate decreased significantly from 13.8% during the first 3 years to 3% during the last 2 years. Good cosmetic results were obtained in 92.3% of cases. The functional result, as judged by the urinary stream, was good in 93.8%. Tubularized incised plate urethroplasty is a simple, quick, single-stage procedure suitable both for mid and distal penile hypospadias repair. It provides an excellent functional neo-urethra, a cosmetically normal looking glans and meatus and is associated with very few complications.