Comprehensive analysis of six years experience in tubularised incised plate urethroplasty and its extended application in primary and secondary hypospadias repair.
OBJECTIVE
We evaluated the potential of tubularised incised plate (TIP) urethroplasty in primary and secondary hypospadias repair focusing on the extended application of this procedure, the utility and handling of the urethral plate and operative results.


METHODS
In this retrospective study, we analysed the medical records of 228 children with different levels of the hypospadiac meatus who underwent a TIP procedure between February 1997 and December 2002. The children were followed a mean of 42 months. Our medical records provided us with details about the location of the hypospadiac meatus, the width of the urethral plate before and after midline incision, primary versus secondary surgery, complications as well as notes on the extended application of the TIP procedure.


RESULTS
The overall postoperative complication rate was 7.8%. The overall fistula rate was 5.7%, with 4.1% in primary distal, 9.6% in primary proximal and 7.5% in secondary repair respectively. We had one case of meatal stenosis (0.4%) and one of urethral stricture (0.4%) and 3 cases of glandular dehiscence (1.3%). Due to the encouraging results, the frequency of TIP procedure in hypospadias surgery increased from 33% in 1997 to 82% in 2002.


CONCLUSIONS
In our study the TIP procedure has emerged as the first-choice technique in primary hypospadias repair--irrespective of the level of the hypospadiac meatus and the width of the original urethral plate. This procedure has also proved to be favourable for many cases at secondary surgery.
Riccabona
Marcus
M
Department of Paediatric Urology, Krankenhaus Barmherzige Schwestern, Seilerstätte 4, A-4010 Linz, Austria. marcus.riccabona@bhs.at
Oswald
Josef
J
Koen
Mark
M
Beckers
Goedele
G
Schrey
Anton
A
Lusuardi
Lukas
L
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000175:diagnosis* / Q000601:surgery*; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D013524:Surgical Flaps; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D013519:Urogenital Surgical Procedures / Q000009:adverse effects / Q000379:methods*