Tubularization of the incised urethral plate [Snodgrass procedure] for distal and midpenile hypospadias repair

ABSTRACT

To evaluate tubularized incised plate urethroplasty [TIPU] in management of distal and midpenile hypospadias. Thirty-two boys [mean age 5.4 years] underwent tubularized incised plate urethroplasty.Twenty-five boys had distal and seven had mid-penile hypospadias. The operation -involved incision of the urethral plate, which was, then tubularized [Snodgrass procedu re]. The neourethra was then covered with a deepithelialized pedicled dartos flap from the inner prepuce before glans and skin closure. With a mean follow-up of 10 months [range 3-14], there were seven complications. Four patients developed a fistula, spontaneous closure occurred in two cases by regular dilatation while the remaining two cases required surgical closure. Two patients had meatal stenosis and responded to meatal dilatation and one patient had complete breakdown of the neourethra. The cosmetic appearance in the other patients is that of a normal slit-like terminal meatus. Tubularized incised plate urethroplasty is considered to be a successful technique for correction of distal and midpenile hypospadias with few complications and superior cosmetic results: