Tubularized incised plate repair for penoscrotal hypospadias: role of surgeon's experience.
OBJECTIVE
To give a retrospective analysis of factors affecting outcome of tubularized incised plate (TIP) repair for penoscrotal hypospadias.


METHODS
Data of all patients who underwent TIP repair for penoscrotal hypospadias by a single surgeon were retrieved. Follow-up was carried out every 3 months within the first year and annually thereafter. Repairs were divided into 2 groups: Group 1 included surgeries performed in the first 2 years after fellowship training, and group 2 included repairs performed afterward. Chi-square test was used for statistical analysis. Statistical significance was defined as P<.05.


RESULTS
Data for 90 patients were retrieved for july 2001 through march 2009: Group 1 included 20 patients and group 2 included 70. The neourethra was covered with spongioplasty in 25 and dartos flap in 65. The overall success rate was 86%. Group 2 patients showed a statistically significant higher success rate of 91% compared with only 65% for group 1. Use of dartos flap was associated with statistically significant higher success (92%) compared with coverage of the neourethra with spongioplasty (68%). In group 1, use of dartos flap was associated with statistically significant better success (82% vs 33%). In group 2 patients, use of dartos flap showed no statistically better success (94% vs 81%).


CONCLUSIONS
TIP is a valid procedure for repair of penoscrotal hypospadias with chordee<30 degrees. The overall success (86%) is satisfactory. Surgeon's experience is the pillar for better success.
Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt. athafez@yahoo.com
Ashraf T
AT
Hafez
Tamer
T
Helmy
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D059032:Learning Curve; D008297:Male; D010409:Penile Diseases / Q000453:epidemiology; D010413:Penis / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012611:Scrotum / Q000601:surgery; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome; D014522:Urethral Diseases / Q000453:epidemiology; D014548:Urinary Fistula / Q000453:epidemiology; D013519:Urogenital Surgical Procedures; D014572:Urology