Evaluation of tubularized incised-plate urethroplasty for hypospadias repair

Abstract

The aim of the present study was to evaluate tabularized incised plate urethroplasty for hypospadias repair regards cosmetic and functional results. This study included 30 patient (aged 1-26 years); 26 with distal, 3 with mid-penile and I with proximal hypospadias. T.l.P. urethroplasty was done for all of them. Two patients with distal hypospadias had previous failed repair and 3 patients with distal penile hypospadias were circumcised. Four patients with ventral chordee were corrected with degloving and tunica albuginea placation in 2. Two patients with coronal hypospadias and 4 with distal penile hypospadias were associated with thin proximal urethra necessitating dissection to healthy urethral spongiosum. All patients had a method of urinary diversion (12 with urethral stent, I 0 with indwelling catheter, and 3 with suprapubic tube) except 5 patients were non-stented. Postoperative dressing was removed in the 5"' day after surgery. Follow up was done for 6 months and the patients are • scheduled for routine follow up. Uroflowmetry was done for selected

cases.

Cosmotic results revealed that T.l.P urethroplasty was successful in

23 patients (76.7% of cases) in whom the external urethral meatus was

011hotopic and slit shaped but only I patient (3.3% of cases) complained of meatal stenosis, while the main complications was urethrocutaneous fistula in 4 patients (I 3.3% of cases). Urethrocutaneous fistula was single, tiny and at original hypospadiac meatus. Complete disruption of sutures occurred in 2 patients (6.7% of cases) with distal penile hypospadias. Secondary procedures were required in 7 patients (23.3% of cases). Secondary procedures included fistula closure in 4 patients, meatotomy for meatal stenosis in I patients and secondary T.l. P urethroplasty in 2 patients.