Outcome of Tubularized Incised Plate (TIP) Urethroplasty according to the Type of Middle Hypospadias

Lee, Wan; Seo, Young Jun; Lee, Sang Don

Abstract

PURPOSE: The outcomes of a tubularized incised plate (TIP) urethroplasty were evaluated according to the type of middle hypospadias repair.
MATERIALS AND METHODS
A total of 36 TIP urethroplasties were performed for middle hypospadias. The medical records of all patients; the level of meatus, age at surgery, outcome, complications, method of second operation and their outcomes etc, were retrospectively reviewed. The mean age of the patients at the time of the operation and the follow up period were 5 years 6 months (12 months to 43 years) and 8.8 months (3 months to 2 years), respectively. The initial types of hypospadias were distal penile in 14 patients, mid-shaft in 11 and proximal penile type in 11, repectively.
RESULTS
The success rates of first operation, according to the type of middle hypospadias, were 12/14 (85.7%) in the distal penile, 8/11 (72.7%) in the mid-shaft and 9/11 (81.8%) in the proximal penile types (overall success rate: 80.6%). The complication rates with the distal penile, mid-shaft and proximal penile types were 14.3, 27.3 and 18.2%, respectively (overall complication rate: 19.4%). Urethrocutaneous fistula and retrusive meatus occurred in 4 and 3 patients, respectively. All of the urethrocutaneous fistulas were successfully covered with 3 fistulectomies and 1 TIP urethroplasty. All the retrusive meatus were repaired with a TIP urethroplasty, but only 1 case was successful. Meatal stenosis did not occur in any of the cases. Overall success rate of the second operation was 34/36 patients (94.4%).
CONCLUSIONS
This preliminary experience indicated that there was no significant difference in the outcomes of a TIP urethroplasty according to the type of middle hypospadias.