Comparison of the Surgical Outcome between Onlay Island Flap and Tubularized Incised Plate Urethroplasty in Hypospadias Repair

Hyun, Ji hwan; Shin, Jae Sung; Park, Kwan Hyun

Abstract

PURPOSE: The onlay island flap and tubularized incised plate (TIP) urethroplasty commonly preserve the urethral plate during each procedure, but there is a dearth of comparative data. Thus, we retrospectively reviewed our clinical data to compare the surgical outcome of the onlay and TIP urethroplasty for hypospadias correction.
MATERIALS AND METHODS
We performed onlay urethroplasty in 23 patients and TIP urethroplasty in 28 patients between 1995 and 2002. The age at the time of surgery, operation time, postoperative complications, and the duration for the development of complications in each procedure were compared.
RESULTS
Among the 28 cases of TIP urethroplasty, 21 were primary, 6 were secondary, and the last case was a tertiary repair, while all of the 23 cases of onlay urethroplasty were primary (age range: 8 month to 11 year). The most common complication in both procedures was urethrocutaneous fistula. Residual curvature was more common in the onlay urethroplasty group. Delayed complications, which developed later than 6 months after surgery, were 30% in both groups. The success rate was similar between the two groups, but the TIP urethroplasty group illustrated a significantly shorter operation time than the onlay group.
CONCLUSIONS
The most common complication was fistula in both the onlay and TIP urethroplasty groups. Even though the success rate was similar in both groups, the operation time of the TIP urethroplasty group was shorter than that of the onlay group. Also, the TIP urethroplasty procedure resulted in more acceptable cosmetic results including a slit like neourethral meatus.