Hypospadias, Re-operative, Tubularized Incised Plate, Urethroplasty
Conditions
Brief summary
The aim of this study is to evaluate the outcomes, feasibility, and complication profile of re-operative hypospadias repair using tubularized incised plate urethroplasty as a single-stage procedure in a single-center experience.
Detailed description
Hypospadias repair remains one of the most common reconstructive procedures in pediatric urology; however, re-operative hypospadias represents a challenging subset due to distorted anatomy, urethral plate scarring, deficient local tissues, and higher complication rates compared with primary repairs. The tubularized incised plate (TIP) urethroplasty, originally described by Snodgrass, revolutionized primary hypospadias repair and has since been adapted for selected reoperative cases. Contemporary evidence suggests that despite prior surgery and scary, a well-vascularized urethral plate of adequate width can still be successfully tubularized following a midline relaxing incision, offering acceptable functional and cosmetic outcomes.
Interventions
All procedures were performed under general anesthesia using the tubularized incised plate technique. After completing penile degloving and exposure of the urethral plate, a midline longitudinal incision was made along the entire length of the plate to allow tension-free tubularization. The urethral plate was then tubularized over an appropriate-sized urethral catheter using fine absorbable sutures. A well-vascularized dartos flap was harvested and interposed as a protective layer over the neourethra, followed by meticulous skin closure.
Sponsors
Tanta University
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
1 Years to 16 Years
Healthy volunteers
No
Inclusion criteria
* Both sexes. * Children with recurrent or residual hypospadias in whom the urethral plate is deemed suitable for reuse, defined as a plate width of at least 8-9 mm with acceptable vascularity and without severe fibrosis.
Exclusion criteria
* Patients with severely scared or fibrotic urethral plates are not suitable for tubularization. * Absent or destroyed urethral plates following previous failed hypospadias repairs. * Patients require staged urethral reconstruction rather than a single-stage procedure. * Presence of poor urethral plate vascularity or ischemic tissue. * Extensive penile scarring or fibrosis resulting from multiple previous surgical attempts. * Severe penile curvature requiring excision of the urethral plate. * Inability to achieve adequate, well-vascularized tissue coverage over the neourethra.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Success rate | 6 months after the procedure | The success rate of tubularized incised plate urethroplasty reoperation after treatment was recorded. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of complications | 6 months after the procedure | Incidence of postoperative complications such as fistula, meatal stenosis, glans dehiscence, and urethral stricture were recorded. |
| Incidence of postoperative urethrocutaneous fistula | 6 months after the procedure | Incidence of postoperative urethrocutaneous fistula was recorded. |
| Incidence of meatal stenosis | 6 months after the procedure | Incidence of meatal stenosis was recorded. |
Countries
Egypt
Outcome results
None listed