Tubularized Incised-plate Urethroplasty: Expanded Use in Primary and Repeat Surgery for Hypospadias / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Tubularized incised-plate (TIP) urethroplasty has recently been successfully applied to all varieties of hypospadias, and also employed for those with no abundant local skin flap following failure of a hypospadias repair. We evaluated the impact of TIP urethroplasty on primary and repeat hypospadias repairs. MATERIALS AND METHODS: Between January 2000 and December 2002, 17 primary and 6 repeat hypospadias repairs were performed by a one surgeon using TIP procedures. We retrospectively analyzed age at surgery, surgical outcomes and complications following correction of a hypospadias. RESULTS: Of the 17 primary hypospadias repairs, the mean patient age and follow-up period were 10, ranging from 0.8 to 34 years, and 13.8, ranging from 2 to 33 months, respectively. The average urethral plate width was increased after a midline incision from 6.8mm to 14.3mm in length. Early complications developed in 7 patients (41.2%), including 4 fistulas, 2 meatal stenoses and 1 wound infection, while there were 3 cases of complications that had to be corrected (17.6%), including 1 meatal stenosis and 2 fistulas. Of the 6 repeat hypospadias repairs, the mean patient age and follow-up period were 10.7 years ranging from 2 to 21 years, respectively and 12.5, ranging from 2 to 33 months, respectively. Two fistulas (33.3% complication rate) developed following the repeat TIP repairs. CONCLUSIONS: TIP urethroplasty is a versatile operation, which can give excellent functional and cosmetic results in patients requiring primary or revisional hypospadias surgery. However, the TIP procedure should not be indicated in repeat hypospadias surgery if the urethral plate has been resected, or is obviously scarred.