Functional evaluation of tubularized-incised plate repair of midshaft-proximal hypospadias using uroflowmetry.
OBJECTIVE
To determine objectively, using uroflowmetry, the functional results of the tubularized-incised plate urethroplasty to repair midshaft-proximal hypospadias.


METHODS
Twenty-one patients (mean age 4 years, mean follow-up 1.8 years) were selected from those undergoing surgery between January 1996 and January 1998 at our institution. All patients had midshaft-proximal hypospadias and were treated using the Snodgrass technique. Patients were included if they were able to void volitionally and had no fistula. The flow pattern, maximum (Qmax) and mean flow rate (Qave) were measured; the results were expressed as percentiles and compared with published values from normal children. The Qmax and Qave were considered normal if > 25th percentile, as equivocally obstructed when in the 5-25th percentile and obstructed if < 5th percentile.


RESULTS
Fourteen patients were considered normal, four as equivocally obstructed and three as obstructed. Of the second group, one patient had a urethral diverticulum at the native meatus (confirmed by voiding cysto-urethrography) and the remaining three patients had meatal stenosis that responded to dilatation, with normal flow in two and improvement in the other. Of the obstructed group, one patient responded to dilatation and two underwent meatoplasty.


CONCLUSIONS
The tubularized-incised plate repair provides satisfactory functional results for midshaft-proximal hypospadias; uroflowmetry is an important noninvasive tool to evaluate this technique. A long-term follow-up is needed to confirm these results.
Marte
A
A
Department of Paediatrics, Paediatric Surgery, 2nd University of Naples, Naples, Italy. amarte@tin.it
Di Iorio
G
G
De Pasquale
M
M
Cotrufo
A M
AM
Di Meglio
D
D
D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000503:physiopathology / Q000601:surgery*; D007223:Infant; D008297:Male; D013524:Surgical Flaps; D016896:Treatment Outcome; D014554:Urination / Q000502:physiology; D014563:Urodynamics / Q000502:physiology