title: Foreskin reconstruction and preservation of a thin distal urethra: a challenge in tubularized incised plate urethroplasty.
abstract: OBJECTIVE
  The aim of this retrospective study was to evaluate the functional and cosmetic outcome of tubularized incised plate urethroplasty (TIPU) with preputial reconstruction and preservation of a thin distal urethra when applicable.
  
  
  METHODS
  The records of 64 boys with hypospadias, who underwent TIPU between 2000 and 2007 were analyzed. 33 (52%) underwent foreskin reconstruction and a thin distal urethra was preserved and incorporated in 19 (30%) patients. The Hypospadias Objective Scoring Evaluation (HOSE), Pediatric Penile Perception Score (PPPS), and uroflowmetry were evaluated in 55 boys (86%) after a mean of 4.8 years.
  
  
  RESULTS
  All patients had a vertically oriented meatus. The overall rate of fistula occurrence was 9% and of wound dehiscence, 5%. Among 33 preputial reconstructions, two (6%) patients had dehiscence and three (9%) had a fistula. No cases of stricture or stenosis occurred. There were significantly more complications with reconstruction of the foreskin (p = 0.012) and preservation of a thin distal urethra (p = 0.021). Uroflowmetry was normal in 76% of patients. PPPS and HOSE revealed excellent results.
  
  
  CONCLUSIONS
  TIPU produces excellent cosmetic and functional results with few complications; complications are more common after foreskin reconstruction and use of a thin distal urethra.
authors: General Hospital Klagenfurt, Klagenfurt, Austria. guenter.fasching@kabeg.at
authors: Gunter
authors: G
authors: Fasching
authors: Christoph
authors: C
authors: Arneitz
authors: Gabriele
authors: G
authors: Gritsch-Olipp
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D005500:Follow-Up Studies; D052816:Foreskin / Q000601:surgery*; D006801:Humans; D007021:Hypospadias / Q000503:physiopathology / Q000601:surgery*; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014521:Urethra / Q000601:surgery*; D014563:Urodynamics; D013521:Urologic Surgical Procedures, Male / Q000379:methods*