title: Modified tubularized incised plate urethroplasty in distal hypospadias repair: Stepwise technique with validated functional and cosmetic outcome.
abstract: OBJECTIVE
  To describe modification of the tubularized incised plate urethroplasty (TIP) for distal hypospadias, and assess its efficacy, and functional and cosmetic outcomes.
  
  
  METHODS
  A prospective evaluation of a consecutive series of patients operated for primary distal hypospadias was conducted at a tertiary reference center. A standardized modification of the TIP (mTIP) procedure was performed on a 10 French catheter. Clinical data were collected in a dedicated database. Intraoperative variables, postoperative complications and outcomes, by means of uroflowmetries and a validated (HOPE) questionnaire, were assessed. Efficacy was evaluated with the reported complications: functional outcome was evaluated with uroflowmetries and cosmetic assessment by a validated questionnaire (HOPE). A descriptive statistical analysis was performed.
  
  
  RESULTS
  Of the 112 boys operated between 30/09/2011 and 1/04/2014, 50 completed long-term follow-up with functional and esthetic evaluation, as required for inclusion. Median age at surgery was 25 months (range 14-156); median follow-up time was 21.5 months (range 6-48). Complications requiring re-intervention occurred in 2/50 boys. Uroflowmetry presented a bell-shaped curve in 47/50 boys, and the median HOPE score was 9.5 (range 7.6-10.0).
  
  
  CONCLUSIONS
  The mTIP procedure provided satisfactory long-term functional and cosmetic outcomes, as validated by uroflowmetries and standardized questionnaire.
authors.affiliation: Department of Urology, Ghent University Hospital, Ghent, Belgium.
authors.forename: A-F
authors.initials: AF
authors.lastname: Spinoit
authors.affiliation: Department of Paediatric Surgery and Urology, Leeds Teaching Hospital, Leeds, UK.
authors.forename: A
authors.initials: A
authors.lastname: Radford
authors.affiliation: Department of Paediatric Surgery and Urology, Leeds Teaching Hospital, Leeds, UK.
authors.forename: J
authors.initials: J
authors.lastname: Ashraf
authors.affiliation: Department of Paediatric Surgery and Urology, Leeds Teaching Hospital, Leeds, UK.
authors.forename: M
authors.initials: M
authors.lastname: Gopal
authors.affiliation: Department of Paediatric Surgery and Urology, Leeds Teaching Hospital, Leeds, UK. Electronic address: ramnath.subramaniam@leedsth.nhs.uk.
authors.forename: R
authors.initials: R
authors.lastname: Subramaniam
mesh_terms: D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000503:physiopathology / Q000601:surgery*; D007223:Infant; D008297:Male; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome; D014563:Urodynamics / Q000502:physiology*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*
keywords: Hypospadias; Urethroplasty; Uroflowmetry; Validated questionnaire