Comparative Study Between Tubularized Incised Urethral Plate and Tubularized Incised Plate with Preputial Graft in Hypospadias Repair

Abstract

Background: Hypospadias is a common congenital anomaly, affecting approximately 1 of 300 live male births making hypospadias the second most common birth defect in boys after cryptorchidism. there are more than 100 techniques for urethral reconstruction among these techniques the tubularized incised urethral plate (TIP) which was proposed by Snodgrass in 1994 has been the most popular technique for the repair of primary hypospadias. Objective: To study the difference between tubularized incised urethral plate and tubularized incised plate with preputial graft in hypospadias repair. Patient and methods: This prospective randomized study included sixty patients suffering from hypospadias who was admitted to the urology department of Menoufia and Kafr El-Sheikh University Hospitals from December 2018 to June 2020 which were randomized into two groups; group I underwent the classic TIP repair and group II underwent TIP repair with inlay preputial graft. Operative details, postoperative complications were reported also uroflowmetry was done for all cases at the 3rd and 6th months postoperatively. Results: There was no significant difference between both techniques regarding the postoperative complications and overall success rate (P 0.718) which were 83.3% and 86.7% in A and B respectively. The uroflowmetry at 3rd month postoperatively showed no significant groups difference in Q max between both groups (p >0.05) while there was a significant improvement in Q max in the 6th month in the grafted group (p. 0.001) Conclusion: despite both the classic TIP repair and TIP with preputial graft were comparable according to the overall success rate and postoperative complications the grafted TIP was more superior to classic TIP in the functional outcomes which were assessed by the uroflowmetry (Q max).