Outcome of Tubularized Incised Plate (TIP) Urethroplasty for Hypospadias Reoperation

Lee, Wan; Shin, Dong Gil; Lee, Sang Don

Abstract

PURPOSE: We evaluated the outcomes of a tubularized incised plate (TIP) urethroplasty on reoperative hypospadias repairs.
MATERIALS AND METHODS
A total of 17 reoperative hypospadias repairs were performed. We retrospectively reviewed the medical records of all patients, which included the level of meatus, technique of repair, age at surgery and complications. The mean patient age and number of prior repairs were 6.3 years and 1.6 times, respectively. Before the reoperation the level of meatus was the anterior type in 2, the middle type in 7 and the posterior type in 8 patients.
RESULTS
The follow-up periods ranged from 1 to 35 months (average 18.5 months). The success rates, according to the type of hypospadias, were 2/2 (100%) in the anterior type, 4/7 (57.1%) in the middle type and 6/8 (75%) in the posterior type (70.6% overall success rate). The patients had undergone TIP repairs (5), Denis-Brown-Crawford flaps (2), Thiersch-Duplay tubes (2), Mathieu repairs (1), onlay island flaps (1), transverse prepubital island flaps (TPIF) (1), a TPIF and Mathieu repair (1) and Flip-flaps (1), with an unknown (3) as the primary procedures. An urethrocutaneous fistula occurred in 3 patients, and 1 each of meatal stenosis and a glans repair breakdown also occurred (29.4% overall complication rate). Fistula repairs were successfully performed 7, 9 and 10 months later in the 3 patients. The patient with meatal stenosis was treated with simple dilatation.
CONCLUSIONS
This preliminary experience provides further proof of the versatility of TIP urethroplasty, showing its potential use following a reoperative hypospadias repair.