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Published in:

01-11-2016 | Original Article

Improved outcomes after technical modifications in tubularized incised plate urethroplasty for mid-shaft and proximal hypospadias

Authors: Yuk Him Tam, Kristine Kit Yi Pang, Yuen Shan Wong, Siu Yan Tsui, Hei Yi Wong, Jennifer Wai Cheung Mou, Kin Wai Chan, Kim Hung Lee

Published in: Pediatric Surgery International | Issue 11/2016

Abstract

Purpose

To investigate and compare the outcomes after tubularized incised plate (TIP) urethroplasty in mid-shaft and proximal hypospadias using a standard and a modified technique.

Methods

We conducted a retrospective study in 104 consecutive children who underwent mid-shaft or proximal TIP repairs from Jan 2007 to Sept 2015. Patients in Cohort One had dorsal dartos (DD) neourethral coverage while patients in Cohort Two had either de-epithelialized split preputial (DESP) or tunica vaginalis (TV) flap coverage. TV flap was used only when DESP flap was not sufficient to cover the neourethra.

Results

There were 52 patients each in Cohort One (DD, n = 52) and Cohort Two (DESP, n = 38; TV, n = 14) with no difference in ratio of mid-shaft/proximal between the two cohorts. At a median follow-up of 28 months, 36 patients (34.6 %) developed 47 complications including fistula (n = 19; 18.3 %) and neourethral dehiscence (n = 4; 3.8 %). Cohort One patients had significantly more fistula (28.8 vs 7.7 %; p = 0.005) and neourethral dehiscence (7.7 vs 0 %; p = 0.04) than Cohort Two. There was no difference between the two cohorts in the complication rates of meatal stenosis, recurrent ventral curvature and neourethral stricture.

Conclusions

Both DESP and TV flap appear to be superior to DD in preventing fistula and neourethral dehiscence in non-distal TIP repairs.

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Title: Improved outcomes after technical modifications in tubularized incised plate urethroplasty for mid-shaft and proximal hypospadias
Authors: Yuk Him Tam
Kristine Kit Yi Pang
Yuen Shan Wong
Siu Yan Tsui
Hei Yi Wong
Jennifer Wai Cheung Mou
Kin Wai Chan
Kim Hung Lee
Publication date: 01-11-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 11/2016
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-016-3954-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Improved outcomes after technical modifications in tubularized incised plate urethroplasty for mid-shaft and proximal hypospadias

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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