Clinical Study On Urethral Plate Preseving Hypospadias Repair

Objectives:The tubularized incised-plate (TIP) urethroplasty is gaining an ever increasing popularity in hypospadias repair because of its low complication rates and favorable cosmetic and functional results published in recent years. However, most of the advocates did not mention specifically the indications of their surgical choice for the TIP procedure. We report a cohort of 171 boys non-selectively scheduled for primary hypospadias repair with TIP procedure at the Soochow University Children's Hospital.Methods:Between March 2000 and December 2005, 171 virgin cases of hypospadias were non-selectively scheduled for TIP urethroplasty. The median age at the time of surgical repair was 3.0 years old (10 months to 16 years). The position of the meatus was distal in 65 boys (38%), middle in 29 (17%) and posterior in 77 (45%) according to Barcat classification. The severity of chordee was graded into 0-4 according to the etiological classification on congenital chordee. Postoperatively temporary urine diversion was carried out with either suprapubic or urethral stent tube for about 8-14 days.Results:TIP urethroplasty could be carried out in 161 patients. All patients were followed up after surgical repair for 2～61 months (median 16 months). Of 161 patients undergoing TIP urethroplasty, 129 (80.1%) were successful cured, obtaining a neourethra with slit-like meatus at the tip of the glans and satisfactory voiding function. Small urethrocutaneous fistula occurred in 26 (16.1%) cases, urethral dehiscence in one (0.6%) and meatal retrusion in two (1.2%). Two patients (1.2%) developed mild meatal stenosis and were successfully managed by simple dilatation. Reccurent chordee were found in...