Clinical application of standardized tubularized incised plate urethroplasty for pediatric hypospadias

Abstract

Objective To explore the efficacies and outcomes of standardized tubularized incised plate (TIP) urethroplasty for pediatric hypospadias. Methods A total of 447 hypospadias children with a median age of 21(5-176) months were recruited.There were 175 cases (39%) aged under 18 months and 272 cases (61%) aged above 18 months.The clinical types were distal (n=160, 36%), middle (n=216, 48%) and proximal (n=71, 16%). There were 281 cases (63%) in senior group and 166 cases (37%) in junior group.The differences of postoperative complications among different anatomical types were analyzed.Chi-square test was employed for analyzing and comparing the differences of postoperative complications among children of different age groups and the differences of postoperative complications among physicians of different seniority using standardized surgical procedures.Age, anatomical factors and seniority of physicians were included.And binary logistic regression analysis was performed for analyzing the influencing factors of operative success rate. Results All operations were performed successfully.There was no postoperative onset of urethral skin fistula, urethral stricture, urethral diverticulum, penile curvature or penile occultation.The incidence of surgical complications varied among children with different anatomical types.Eight cases (5%) of distal penis type had the lowest level and the difference was statistically significant as compared with another two types (P=0.000). No significant difference existed in the incidence of postoperative complications among physicians with different seniority (P>0.05). No significant difference existed in the incidence of postoperative complications among children of different age groups (P>0.05). Binary logistic regression analysis indicated that operative success rate or value of physicians with different seniority was 0.902 (0.508-1.604) and the difference was not statistically significant (P=0.726). Conclusions TIP is effective for children with hypospadias of all ages.The success rate of distal operation is relatively high and it is convenient for training pediatric urologists. Key words: Hypospadias; Postoperative complications; Child