Tubularized incised plate urethroplasty in adults under local anaesthesia

Abstract

IntroductionOur aim was to assess our TIP urethroplasty results in adults with local anaesthesia. Materials and methodsMedical records of adult patients who underwent TIP urethroplasty due to distal hypospadias in our clinic between April 2006 and May 2013 were reviewed. Patient's age, external urethral location, preoperative calibration size of urethra, primary or secondary or more, circumsized or uncircumsized conditions were recorded. The records were categorized as circumcised–uncircumcised, urethral stent calibration 16Fr and above or 14Fr and below, primer or seconder and above, special group or the others. SPSS 16.0 were used for statistical assessment and chi-square test was used to determine success. p<0.05 was considered to show statistical significance. Results51 patients underwent distal hipospadias repair under local anaesthesia in our clinic between April 2006 and May 2013. Mean age was 21.3. 24 patients had coronal, 26 patients had subcoronal, 1 patient had glanuler hypospadias. 40 patients were primary, 7 secondary, 4 tertiary. 38 patients were circumsized. 13 patients were uncircumsized. Mean preoperative calibration was 14.8Fr, mean urethral stent calibre was 15, 1Fr, mean stent duration time was 5.9 day. Suprapubic catheter was used for drainage at 48 patients. 22(52.3%) were successful, 20(47.6%) were unsuccessful of 42 patients with follow up. 13 patients that had fistula underwent fistula repair after 3 months later under local anaesthesia. 2 patients had stricture and they underwent meatotomy and dilatation. On one patient, second TIP urethoplasty operation was performed because the first operation was unsuccessful. Operation was very successful and it upgraded our over all success to 90.4%. An optimal group as primary, uncircumcised, 16Fr neourethra was formed and were compared with the other groups. Success rate between optimal group and others was not different statistically. ConclusionOur success rate was similar to literature. This survey reveals that distal hypospadias repair can be performed under local anaesthesia.