Further experience with the tubularized-incised urethral plate technique for hypospadias repair.
OBJECTIVE
To report further experience of hypospadias repair using the tubularized-incised urethral plate (TIP) technique and to evaluate the role of postoperative neourethral dilatation as a method of preventing complications.


METHODS
The study included 64 patients (aged 2-18 years) who underwent TIP repair of hypospadias; 47 required a primary and 17 a secondary repair. After removing the stent they were randomized into two groups; group 1 (38 patients) underwent regular neourethral dilatation for 12 weeks and group 2 (26 patients) did not. Patients were followed for a mean (range) of 28 (6-52) months.


RESULTS
The functional and cosmetic results were excellent in all patients in group 1, except for slight meatal regression in one patient (3%). In group 2, 17 patients had excellent results; eight (31%) were re-operated upon to correct complications, six developed a fistula (four of which were associated with meatal stenosis) and two developed a neourethral stricture.


CONCLUSIONS
TIP urethroplasty is a versatile technique that provides an excellent functional and cosmetic outcome. Regular urethral calibration after repair should be considered as an integral part of the technique, to prevent neourethral and/or meatal stenosis with subsequent fistula formation.
Elbakry
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Department of Urology, Suez Canal University, Ismailia, Egypt. elbakry1@egyptnetwork.com
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D012008:Recurrence; D013524:Surgical Flaps; D014521:Urethra / Q000637:transplantation*