High odds for freedom from early complications after tubularized incised-plate urethroplasty in 1-year-old versus 5-year-old boys.
OBJECTIVE
We present two parallel case series on outcome after tubularized incised-plate urethroplasty (TIP repair) for hypospadias in 1-year-old versus 5-year-old boys.


METHODS
Over a 2-year period two groups (1 year old, n=57 and 5 years old, n=65) of boys were operated in parallel using the TIP repair. Main endpoints were set as incidence of fistula, meatal stenosis and foreskin dehiscence/phimosis. A logistic regression model was used to predict the odds for freedom from either 'any complication' or fistula in 1-year-old boys versus 5-year-old boys.


RESULTS
Five-year-old boys had a significantly higher incidence of fistula (26% vs. 7%, P<0.01) and 'any complication' (50% vs. 18%, P<0.001) than the 1-year-old boys. The odds ratio for freedom from 'any complication' and fistula was 4.8:1 (P<0.001) and 4.7:1 (P=0.009), respectively, in favor of the 1-year-old group. Avoiding foreskin reconstruction gave increased odds for freedom of "any complication" (4.2:1, P=0.034), but was an insignificant factor concerning freedom from fistula.


CONCLUSIONS
These data substantiate why boys with hypospadias should be corrected early. Foreskin reconstruction increases postoperative problems but does not increase the rate of postoperative fistulae.
Korvald
Christian
C
Department of Plastic and Reconstructive Surgery, Rikshospitalet University Hospital, Sognsvannsveien 20, N-0027 Oslo, Norway. christian.korvald@rikshospitalet.no
Stubberud
Kjetil
K