Abstract
Background: Hypospadias is a congenital penile defect and Tubularized Incised Plate (TIP) urethroplasty is a widely accepted option to repair this defect. Our experience about the outcome of hypospadias repair by this technique is discussed. Methods: This is a retrospective analytical study consisting of 80 cases, conducted between May 2017 to December 2019 at the Department of Pediatric Surgery, Maternity, and Children’s Hospital Dammam. All the cases with anterior, middle, and posterior hypospadias, who underwent Snodgrass TIP urethroplasty, were included in the study. The same surgeon performed all the operations. The follow-up period lasted for 2 years, after surgery and the final outcome of the procedure was recorded, based on the observations. Results: The age range of the patients varied between 1 to 9 years. Anterior hypospadias constituted 64 (80%) cases followed by middle hypospadias 13 (16.25%), and posterior hypospadias 3 (3.75%). By type, glanular hypospadias was the most common 30 (37.5%), followed by sub-coronal 19 (23.75%), coronal 15 (18.75%), mid-penile 11 (13.75%), proximal penile 2 (2.5%) and penoscrotal hypospadias 2(2.5%). Scrotal hypospadias was the least common type, 1 (1.25%). Overall complications that required re-intervention occurred in 16 (20%) cases. Urethrocutaneous fistula (UCF) which occurred in 7 (8.75) cases was the most common complication, followed by meatal stenosis in 4 (5%) and glans dehiscence and urethral stricture 2 in each (2.5% each). Total repair disruption was the least common complication that was noticed in 1 (1.25%) case. Functional and cosmetic results were judged as satisfactory. Conclusion: For hypospadias repair, TIP urethroplasty is the procedure of choice for anterior hypospadias with excellent results. It is also quite suitable with middle hypospadias and acceptable for posterior hypospadias for selected cases. The overall complication rate is low and also offers very good functional and cosmetic results.
Highlights
Hypospadias a congenital anomaly of the urethra characterized by a meatal opening sited proximal to its normal site develops as the urethral plate could not tabularize completely.[ 1,2] Other features include: ventrally deficient skin; dorsal hooded skin; and penile curvature.[3]
This study presents our experience with the Tubularized Incised Plate (TIP) urethroplasty to manage various types of hypospadias
The most common category was anterior hypospadias populated by 64 boys (80%) followed by mid-penile, in 13 cases (16.25%)
Summary
Hypospadias a congenital anomaly of the urethra characterized by a meatal opening sited proximal to its normal site develops as the urethral plate could not tabularize completely.[ 1,2] Other features include: ventrally deficient skin; dorsal hooded skin; and penile curvature.[3] The incidence is 1 in 200-300 live births.[4] An abnormal penis causes emotional trauma to the family as to the potency and fertility concerns. In 1994, Snodgrass introduced a simple and promising tubularized incised plate (TIP) urethroplasty which received worldwide acceptance.[6] The procedure can address re-do and complex hypospadias.[8] This study presents our experience with the TIP urethroplasty to manage various types of hypospadias. Hypospadias is a congenital penile defect and Tubularized Incised Plate (TIP) urethroplasty is a widely accepted option to repair this defect. Our experience about the outcome of hypospadias repair by this technique is discussed
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