title: Tubularized incised plate urethroplasty for hypospadias reoperations in 100 patients.
abstract: OBJECTIVE
  To determine the key points for a successful redo hypospadias procedure using tubularized incised plate urethroplasty operation.
  
  
  METHODS
  A retrospective chart review of a cohort of 100 patients (Mean age: 4.5 years, range: 2-12) who had undergone a redo tubularized incised plate urethroplasty operation was performed. Fischer exact and Chi square tests were used for statistical analysis.
  
  
  RESULTS
  The incidence of complications of tubularized incised plate urethroplasty reoperation after failed repairs of meatal advancement and glanuloplasty procedure (n: 14), meatal based flap (n: 36), and tubularized incised plate urethroplasty (n: 50) were 29% (n: 4), 22% (n: 8) and, 28% (n: 14) respectively (P > 0.05). The overall complication rate was 26% (n: 26). Eighteen patients (18%) had fistula, five had meatal stenosis (5%), two had dehiscence (2%) and one had neourethral stenosis (1%). Postoperatively, fistula was closed in 18 patients and 5 underwent meatoplasty. Two patients with dehiscence and one with neourethral stenosis underwent an unsuccessful third redo tubularized incised plate urethroplasty reoperation and they were candidates for a complex hypospadias repair (3%). The ultimate success rate of tubularized incised plate urethroplasty reoperation after treatment of complications was 97%.
  
  
  CONCLUSIONS
  Tubularized incised plate urethroplasty is a safe and efficacious alternative procedure for hypospadias reoperations if the urethral plate has no scars and outcome is favourable if the first failed hypospadias repair is a meatal based flap procedure. The complication rate increases if the urethral plate has been previously incised in the midline and a redo third redo must be avoided.
authors.affiliation: Department of Pediatric Surgery and Pediatric Urology, Bakirköy Maternal and Childrens' Hospital, Atakoy 9-10, A8 D:3, Istanbul, 34750, Turkey. mehmetnursen@yahoo.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eliçevik
authors.forename: Gülay
authors.initials: G
authors.lastname: Tireli
authors.forename: Oyhan
authors.initials: O
authors.lastname: Demirali
authors.forename: Murat
authors.initials: M
authors.lastname: Unal
authors.forename: Serdar
authors.initials: S
authors.lastname: Sander
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000379:methods*