RESUMO
Objective To evaluate prospectively our experience using tubularized incised plate (TIP) urethroplasty in primary and repeat penile shaft hypospadias. Patients and Methods Thirty-two boys with penile shaft hypospadias were selected to undergo TIP procedure. Their age ranged from 22 months to 9 years. Twenty-two cases were primary and 10 cases were repeat hypospadias repairs. To correct penile chordee; complete degloving of the penis and lateral dissection of tethering tissues was done in every case. This was followed by tunica albuginea plication in 7 cases; while ellipse excision was needed in 3 cases. Using the preserved urethral plate; single-layer urethroplasty was done in all cases. A vascularized subcutaneous flap (36 cases) or tunica vaginalis (4 cases) was always used to cover the neourethra. A postoperative stent was used for 8 - 12 days in all cases. Results The patients were followed up for a mean of 14.2 months. Postoperative clinical evaluation revealed success rates of 95.5and 90for primary and repeat cases; respectively. Among the primary cases; only one patient had urethro-cutaneous fistula concomitant with meatal stenosis; while among the repeat cases urethro-cutaneous fistula occurred in one patient. No case of urethral stricture or wound dehiscence was encountered. Our criteria for success were a single unimpeded forward-directed urine stream; a straight penis; good cosmesis and no need for further surgery. Conclusion We feel that TIP urethroplasty in primary and repeat cases of penile hypospadias is a reasonable option in cases with chordee not severe enough to necessitate excision of the urethral plate and when midline incision of the plate yields an adequate width amenable to tubularization