Tubularized incised plate urethroplasty for distal and midpenile hypospadias reoperation: A single institute experience

2017 ◽  
Vol 11 (3) ◽  
pp. 178-183
Author(s):  
Elsayed M Salih ◽  
Abdelbaset Elemam ◽  
Mohamed Elfeky ◽  
Abdrabuh M Abdrabuh ◽  
Hussein A Galal
Keyword(s):  
Complication Rate ◽  
Medical Records ◽  
Functional Outcomes ◽  
Alternative Procedure ◽  
Urethral Plate ◽  
Simple Closure ◽  
Meatal Stenosis ◽  
The Third ◽  
Tubularized Incised Plate ◽  
Tubularized Incised Plate Urethroplasty

Objective: Our study aimed to evaluate our experience in tubularized incised plate urethroplasty in distal and midpenile hypospadias reoperation. Patients and methods: This was a retrospective study in which we reviewed the medical records of 56 patients who underwent tubularized incised plate urethroplasty in distal and midpenile hypospadias reoperation. Tubularized incised plate urethroplasty was performed using a surgical technique like the primary tubularized incised plate repair based on the Snodgrass’s method. We recorded complications and functional outcomes of redo procedures. Results: We reviewed 56 patients who ranged in age from 2–16 years (mean 7.02±3.8 years). The overall complication rate was 33.9% ( n=19). Eight patients (14.3%) had fistula, six had meatal stenosis (10.7%), four had dehiscence (7.1%), and one had neourethral stenosis (1.8%). The complications occurred in 13 of mid-penile cases representing 50% of mid-penile cases but occurred in six cases of distal-penile cases (20%). The success rate of tubularized incised plate urethroplasty reoperation was 94.6% after repair of fistula and meatal stenosis by simple closure of fistula and meatoplasty. Conclusion: Tubularized incised plate urethroplasty is a safe and effective alternative procedure for hypospadias reoperations. The outcome is favorable if the urethral plate has no scars and with distal meatal location. The complication rate increases if the third redo is done and with midpenile meatal location.

scholarly journals Redo hypospadias repair by a single surgeon after failed hypospadias surgeries: Experience from a developing country

2020 ◽  
pp. 17-23
Author(s):  
Md. Abdullah Al Farooq ◽  
MA Mushfiqur Rahman ◽  
Tanvir Kabir Chowdhury
Keyword(s):  
Developing Country ◽  
Complication Rate ◽  
Hypospadias Repair ◽  
Urethral Plate ◽  
Meatal Stenosis ◽  
Tubularized Incised Plate ◽  
Tubularized Incised Plate Urethroplasty ◽  
Principal Author

Background: Hypospadias surgeries are often complicated with fistulas, meatal stenosis and disruptions. We report our series of redo surgeries for failed primary repairs. Methods: We prospectively observed all the redo hypospadias repairs done by the principal author between 2013 and 2017. Thiersch-Duplayurethroplasty was done if the urethral plate was adequately wide and intact; tubularized incised plate (TIP) urethroplasty was performed if the urethral plate was intact but, narrower than 8 mm; 2 stage procedures were done with oral mucosal graft (OMG) if the urethral plate was deficient or scarred with significant chordee. Result: There was a total of 31 patients. Age ranged from 18 months to 15 years (mean 8.05 ±4.27 years). Sixteen (51.61%) patients underwent only one surgery, 10 (32.26%) patients underwent 2 surgeries, 2 patients (6.45%) underwent 3 surgeries, and 3 patients (9.68%) underwent 4 surgeries prior to presenting to us before our redo surgeries.We had performed TIP urethroplasty in 16 (51.61%) patients, meatal based flap urethroplasty in 12 (38.71%), OMG followed by urethroplasty in 2 (6.45%), and repair of urethra-cutaneous (UC) fistula in 1 (3.23%) patient. Ten (32.26%) Complications occurred in 8 (25.80%) patients. Unsuccessful repair was noted in 03 (9.67%) patients (UC fistula 1, glans dehiscence with UC fistula 1, and glans dehiscence 1). Conclusion: Thiersch-Duplay and TIP repair can be successfully performed in redo hypospadiassurgeries with acceptable complication rate. OMG graft can be reserved for cases with gross scarring of the urethral plate. Keywords: Failed hypospadias repair; Tubularized incised plate urethroplasty; Thiersch-Duplay; Outcome

scholarly journals The experimental study on the tubularized incised plate (tip) urethroplasty in children on the central India

2018 ◽  
Vol 5 (5) ◽  
pp. 1838
Author(s):  
Shobhita K. Mane ◽  
Santosh Kumar
Keyword(s):  
Experimental Study ◽  
Experimental Research ◽  
Complication Rate ◽  
Central India ◽  
Fistula Closure ◽  
Urethral Plate ◽  
Proximal Hypospadias ◽  
Tubularized Incised Plate ◽  
Tubularized Incised Plate Urethroplasty

Background: The main objective of the present study is assessment of the tubularized incised plate (TIP) urethroplasty. The present study was done in experimental research design.Methods: We had started Tubularized incised plate urethroplasty as developed by Warren Snodgrass in all boys having coronal sub-coronal, distal, mid, and proximal hypospadias where urethral plate is intact.Results: Out of 37 patients 17 patients developed fistulas at different sites, 10 patients had coronal fistula, 2 distal penile and one mid-shaft fistula. 2 patients who had fistula closure with urethroplasty for distal urethra by TIP developed reopening of fistula. 7 patients had thinning of stream out of which 3 patients developed immediate post-operative. It was managed by meatal dilatation. 4 patients complained thinning of stream after l0 days to one month. All patients were advised meatal dilatation. Stream improved later on in 6 patients. In 7 patients fistulas also closed spontaneously.Conclusions: It is also found and concluded that the total number of the complication rate between primary and re-operative in TIP method is very low; it means TIP method is very useful and effective.

scholarly journals Hypospadias in toddlers: a multivariable study of prognostic factors in distal to mid-shaft hypospadias and review of literature

2022 ◽  
Vol 5 (1) ◽  
pp. e000225
Author(s):  
M Reza Roshandel ◽  
Tannaz Aghaei Badr ◽  
Fahimeh Kazemi Rashed ◽  
Samantha Salomon ◽  
Seyyed Mohammad Ghahestani ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Fistula Formation ◽  
Hypospadias Repair ◽  
Urethral Plate ◽  
Factors Affecting ◽  
Tubularized Incised Plate ◽  
Multivariable Regression ◽  
Tubularized Incised Plate Urethroplasty ◽  
Predicting Factor ◽  
Hypospadias Surgery

BackgroundTubularized incised plate urethroplasty is the most common hypospadias repair technique. However, there are unanswered questions and debates about the anatomical prognostic factors affecting the repair outcomes. This study tried to address some of the problems in the studies compromising the results of the current body of literature.MethodsA prospective cohort of 101 males aged 1–3 years undergoing primary distal to mid-shaft hypospadias repair were enrolled in the study. Complications including edema, erection, inadvertent removal of the urethral stent, surgical wound infection, bladder spasm, hematoma, and hemorrhage were evaluated. Studies in the current literature were reviewed to achieve a better perspective for future investigations.ResultsPersistent complications were found in 16 cases (15.8%) including fistula formation, the persistence of chordee, meatal stenosis, glans, and urethral dehiscence. The mean follow-up time was 6.6±3.4 months. In the single-variable analysis, the meatal location, the length and width of the urethral plate, and the reversible acute postoperative events were significantly associated with the complications. Furthermore, fistula formation was associated with acute surgical site infection (p<0.001). However, the multivariable regression study revealed the presurgical meatal location to be the only statistically significant factor (p=0.03). Notably, the glans diameter or glanular groove shape, urethral plate dimensions, or presence of mild chordee were not independently associated with the outcomes (p>0.05).ConclusionsOur study on the toddlers with hypospadias surgery revealed that the location of urethral meatal was the main predicting factor in the development of major complications. Furthermore, the fistula formation at the infected surgical site emphasizes the importance of postsurgical care.

scholarly journals A comparative study of two operative procedures in anterior hypospadias repair: limited urethral mobilization and tubularized incised plate urethroplasty.

2021 ◽  
Vol 28 (11) ◽  
pp. 1578-1584
Author(s):  
Shafiq ur Rehman ◽  
Fareena Ishtiaq ◽  
Zarlish Fazal ◽  
Muhammad Anwar ◽  
Saad Fazal
Keyword(s):  
Hospital Stay ◽  
Functional Outcomes ◽  
Operative Time ◽  
Operation Time ◽  
Cosmetic Appearance ◽  
Tubularized Incised Plate ◽  
Group A ◽  
Tubularized Incised Plate Urethroplasty ◽  
The Mean ◽  
Group B

Objectives: This study is aimed to compare the results of limited urethral mobilization and tubularized incised plate urethroplasty in the management of anterior hypospadias, in terms of cosmetic and functional outcomes, complication rate, operative time, and hospital stay. Study Design: Prospective Randomized Controlled study. Settings: Department of Pediatric Surgery, DHQ Teaching Hospital Sahiwal. Period: January 2019 to December 2020. Material and Methods: A total of 89 patients with anterior hypospadias were included. Patients were divided randomly into two groups. In group A, limited urethral mobilization was performed and in group B, tubularized incised plate urethroplasty was carried out. A self-structured performa was used to collect the data of all patients. Both groups were compared in terms of the operation time, hospital stay, postoperative complications, cosmetic appearance, and functional outcomes. Results: Forty-five patients were included in group A, age ranged from 2.5 to 12 years (mean 4.83years). Forty-four patients were included in group B and their ages ranged from 3.5 to 11years (mean 4.76 years). The operation time was significantly less for group A than for group B. In group A, it ranged from 54 to 69 min with an average time of 60.51 min and in group B from 70 to 88 min, with an average of 79.34 min. The mean hospital stay period in group A was 7.37 days, ranged from 7 to 9 days, and in group B was 11.04 days, ranging from 10 to 13 days. The mean follow-up period in both groups was 7.45 months, ranging from 3 months to 12 months. Meatal stenosis was the most common complication in group A, which developed in 6.66% (n=3) patients. Urethrocutaneous fistula was the most common complication in group B, which developed in 6.81% (n=3) patients. Cosmetic appearance and functional outcome were good and comparable in both groups. Conclusion: Although both techniques, tubularized incised plate and limited urethral mobilization urethroplasty are acceptable modalities for the management of anterior hypospadias. But limited urethral mobilization urethroplasty seems to be a good option due to its simplicity, short hospital stay, significant shorter operative time, low fistula formation rate, and good cosmetic and functional outcomes.

Sign in / Sign up

Export Citation Format

Share Document