title: Unstented tubularized incised plate urethroplasty combined with foreskin reconstruction for distal hypospadias.
abstract: OBJECTIVE
  Urethral stent has recently been proven to be unnecessary for normal healing in an animal model of tubularized incised plate (TIP) urethroplasty. We report our experience with unstented TIP repair combined with foreskin reconstruction for distal hypospadias in children.
  
  
  METHODS
  We retrospectively reviewed the records of 162 children consecutively treated by TIP urethroplasty for a distal or mid-shaft hypospadias without urethral stent over a 6 years period. The mean age +/- SEM at surgery was 15.7 +/- 1.2 months. A foreskin reconstruction was performed with the hypospadias repair in 136 boys (84%). One hundred thirty one children (81%) underwent this surgery as an outpatient procedure.
  
  
  RESULTS
  With a mean follow-up of 12.4 +/- 1.0 months, urethrocutaneous fistula was observed in 9 children (5.6%), and meatal stenosis in 4 (2.5%). Postoperative urinary retention requiring suprapubic catheter insertion was observed in 4 cases (2.5%) without later complications. Cutaneous dehiscence of the reconstructed foreskin occurred in 6 children (4.4%) and phimosis in 13 (9.5%).
  
  
  CONCLUSIONS
  Absence of urethral stent after TIP urethroplasty for distal hypospadias repair does not seem to increase postoperative complication rate. Foreskin reconstruction in distal hypospadias surgery has an acceptable complication rate.
authors.affiliation: Department of Paediatric Urology, Service de Chirurgie Infantile, Hôpital Mère-Enfant, CHU de Nantes, 44093 Nantes Cedex 01, France. marcdavid.leclair@free.fr
authors.forename: Marc-David
authors.initials: MD
authors.lastname: Leclair
authors.forename: Caroline
authors.initials: C
authors.lastname: Camby
authors.forename: Simon
authors.initials: S
authors.lastname: Battisti
authors.forename: Géraldine
authors.initials: G
authors.lastname: Renaud
authors.forename: Valérie
authors.initials: V
authors.lastname: Plattner
authors.forename: Yves
authors.initials: Y
authors.lastname: Heloury
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology; D014521:Urethra / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology