Single stage repair of hypospadias with tabularized incised plate urethroplasty with partial degloving

Hrair Haik Kegham; Alaa Muneer Shakir; Ali Abdulqader Ameen

doi:10.18203/2349-2902.isj20173180

Authors

Hrair Haik Kegham Department of Urology, Al Karama Teaching Hospital, Baghdad, Iraq
Alaa Muneer Shakir Department of Urology, Al Karama Teaching Hospital, Baghdad, Iraq
Ali Abdulqader Ameen Department of Urology, Al Karama Teaching Hospital, Baghdad, Iraq

DOI:

https://doi.org/10.18203/2349-2902.isj20173180

Keywords:

Hypospadias, Iraq, Repair, Single-stage

Abstract

Background: To evaluate tabularized incised plate (TIP) repair for hypospadias which is considered as the gold standard surgery by most surgeons at time being. The study discusses patients' selection, complications, and the outcome.

Methods: Between April 2014 and April 2016, 42 boys, 2.5-10 years old (mean 5±1.6), underwent tabularized incised-plate (TIP) urethroplasty for primary hypospadias. The hypospadias defects included 16 distal (coronal or sub coronal), 15 distal penile and 11 mid shaft defects (5 of them were associated with mild chordae). With 3-6 months (mean 4±1.2) follow-up by history, examination and investigation. We considered the operations were successful in patients without any complications after 3 months from the surgery.

Results: The success rate was 36 patients (86.7%), complications rate were 6 patients (14.3%). In early complications, we reported 3 patients had wound infection followed by wound dehiscence of glansplasty, and 2 patients had dehiscence of the glansplasty without infection, in late complications we reported one case of meatal stenosis with urethrocutaneous fistula, no cases of urethral stricture or diverticulae were reported.

Conclusions: Single-stage repair of distal and midshaft penile hypospadias using tabularized incised-plate urethroplasty with partial degloving is a simple procedure; creates a normal appearing glandular meatus with functional neourethra in normal appearing circumcised penis, with high success and low complication rate in expert hands.

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References

Snodgrass WT, Bush NC. Hypospadias. In: Walash CP; Wein AJ, Kavoussi LR, Partin AW, Craig A, Eds. Peters Campbell’s Urology, 11th ed. Elsevier company. 2016:3399-3430.

Horton CE. Complications of hypospadias surgery. In: Horton CE, Ed. Clinics in Plastic Surgery. Philadelphia: WB Saunders Company; 1988:371.

Jack W, Mc Aninch. Disorders of the male penis and urethra. In: Jack W. Mc Aninch, Tom F, Smith L, Eds. General Urology, 18th Ed. New York: Lang Medical Books/McGraw-Hill. 2013:633-646.

Horton CE, Devine CJ. Hypospadias, Epispadias and Extrophy of the Bladder. In: Aston SJ, Beasly RW, Charles AM, Eds. Grabb and Smith's Plastic Surgery, 5th Ed. Lippincott-Raven publishers, Philadelphia. New York. 1997:1101-1110.

Fuertes ME, Fernanderz JCR, Casado JS, Chaparro LP, Capadon MS, Estevez LR. Surgical treatment of male hypospadias with pediculated transverse preputial flap technique. Arche Esp Urol. 1995;48(8):805-11.

Kim King LR. Method for correcting meatal stenosis after hypospadias repair. J Urol. 1992;39(6):545-6.

Khuri FJ, Hardy BE, Churchill BM. Urological anomalies associated with hypospadias. Urol Clinic North America. 1998;8(3):565.

Duckett JW. Hypospadias. In: Walsh PC, Reik AB, Vanghan ED, Wein AJ, Eds. Campbells’ urology, 7th Ed. Philadelphia: W.B. Saunders company; 1998:2093-2116.

Reynard J, Brewster S, Biers S. Oxford handbook of urology, 3rd ed. Oxford university press; 2013:645-694.

Baskin LS. Hypospadias. In: Stringer MD, Oldham KT, Pierre DE, Eds. Pediatric surgery and urology long termoutcom. Mouriquand Cambridge University Press. 2006:611-620.

Snodgrass WT, Lorenzo A. Tabularised incised plate urethroplasty for proximal hypospadias. BJU Int. 2002;89:90-3.

Belustein CB, Exposit MP, Soslow RA, Felsen D, Poppas P. Mechanism of healing Snodgrass repair. J Urol. 2001;165(1):277-9.

Lorenzo A, Snodgrass WT. Regular dilatation is unnecessary after tabularize incised-plate urethroplasty. BJU Int. 2002;89:94-7.

Guralinick ML, Al-Shammari A, Williot PE, Leonard MP. Outcome of hypospadias repair using the tabularized incised-plate urethroplasty. Can J Urol. 2000;7(2):986-91.