Tubularized Incised Plate Hypospadias Repair for Proximal Hypospadias

Snodgrass, Warren; Koyle, Martin A.; Manzoni, Gianantonio; Hurwitz, Roger A.; Caldamone, Anthony A.; Ehrlich, Richard M.

doi:10.1016/s0022-5347(01)63293-2

Cited by 241 publications

(120 citation statements)

References 4 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…The urethral plate is a well-vascularized tissue with a rich nerve supply, and an extensive muscular and connective tissue backing [15]. The TIP urethroplasty takes advantage of this extensive blood supply under the urethral plate and this probably explains the success of the procedure, as shown by the low fistula rate in the present series (3.5%) and previously (0-7%) [6,7,16,17]. The dorsal midline incision into the urethral plate provides good mobility and a tension-free tubularization.…”

Section: Discussionsupporting

confidence: 60%

Distal hypospadias: which repair?

2002

View full text Add to dashboard Cite

Objective To compare the function, complications and cosmesis after a modified Thiersch-Duplay and Mathieu unstented urethroplasty. Patients and methods Over a 5-year period 381 consecutive patients (not randomized) with distal hypospadias were evaluated. A modified ThierschDuplay with dorsal incised urethral plate tubularization (group A) was undertaken in 170 (45%) and a parameatal based flip-flap Mathieu hypospadias repair (group B) in 211 (55%). No urinary diversion or stent was used in any of the 381 patients. Results In both groups the mean (SD) follow-up was 3.1 (1.4) years. All 381 patients voided spontaneously after surgery and none developed urinary retention needing catheterization. In groups A and B, respectively, the overall late complications were 12 (7.1%) and 32 (15.2%) (P=0.001), with urethrocutaneous fistula in six (3.5%) and 26 (12.3%; P=0.001); secondary surgery for fistula repair was successful in all boys in A and 89% in B. The glanular meatus was a vertical slit in all in group A and 86% in B (P=0.02). In both groups, 71% of the children who are now toilet-trained and standing to void have a good calibre, single and straight urinary stream in a forward direction. Conclusions Stenting or urinary diversion is unnecessary after distal hypospadias surgery. The functional results were good in those standing to void. A more natural vertical slit-like glanular meatus was easily created using the modified Thiersch-Duplay urethroplasty, with a lower fistula rate.

show abstract

Section: Discussionsupporting

confidence: 60%

Distal hypospadias: which repair?

2002

View full text Add to dashboard Cite

show abstract

“…The most crucial part of this repair method is creating a relaxing incision at the bottom of the urethral plate and using a dartos flap as a supportive cover on the neourethra (2,3). Although this method is employed for distal hypospadias, its success for proximal cases has been shown in several published articles (4).…”

Section: Introductionmentioning

confidence: 99%

Tubularized incised plate urethroplasty for hypospadias reoperation: a review and meta-analysis

Mousavi

Aarabi

2014

Int. braz j urol.

View full text Add to dashboard Cite

ARTICLE INfO ______________________________________________________________ ______________________Purpose: Tubularized Incised Plate (TIP) urethroplasty is a technique for urethral reconstruction of hypospadias although there are some controversies for its use in recurrent cases. The aim of this study was to review the results of TIP technique in various studies and the usage of different flaps for covering the repair site. Material and Methods: Extensive Search was performed for articles published between 1994 and 2013 in common electronic databases. The overall TIP complication rates were estimated by a fixed effects model meta-analysis.Results: 17 articles of hypospadia repair using the TIP method were reviewed. All studies performed surgery and repair on the basis of the Snodgrass's method; however, some introduced modifications to the method. The prevalence of complications in repeated TIP surgery was 11.1 to 33.3% and the most prevalent complication in different studies was fistula. Based on the meta-analysis, the overall estimation of complications was 21.8 % (95% CI: 18.3 to 25.5). Conclusion:Most studies performed the incision of the urethral plate to create a supportive coverage upon neourethra, and confirmed its success. We recommend further investigation on using different flaps in well-designed randomized controlled trials to choose the best surgical method for repairing recurrent hypospadias.

show abstract

“…In this study, 61 patients aged between 1-8 years with distal (sub coronal) and midshaft hypospadias underwent TIP urethroplasty at Al-Yarmouk teaching hospital in Baghdad, using the technique as described previously by Snodgrass (18), using 4/0 and 5/0 Vicryl suture for closure of the urethral, dorsal preputual Flap as protective second layer over suture line and urethral stent was used in the anterior urethra with range of 6-8 Fr. Some cases had mild chordee which were managed by degloving penile skin.…”

Section: Methodsmentioning

confidence: 99%

Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

2017

View full text Add to dashboard Cite

Background: Hypospadias is a relatively common congenital defect of the male external genitalia. The objective of this study was to evaluate whether the early removal of urethral stent following TIP Snodgrass repair of hypospadias can reduces postoperative complications of this procedure.Methods: In Al-Yarmouk teaching hospital, the surgical procedure included 61 tabularized incised plate (TIP) repairs for penile hypospadias. The patients were prospectively observed over 36 months and randomized into 2 groups, group (A) was 30 patients where the urethral stent was removed after 24 hours of operation, and group (B) was 31 cases where the stent removed in the 6th postoperative day. Suprapubic urinary diversion was done for all patients. All of the operations were performed by the same surgeon. Complications and cosmetic appearance were documented at last follow-up.Results: The average age of the patients was 3.9 years, urethrocutaneous fistula was observed in 2 cases in group A (6.6 %), while 11 patients had fistula in group B (35.4 %) with a statistically significant difference (p < 0.05). meatal stenosis was reported in 4 patients in (group A) (13.3%), while 12 patients had such complication in group B (38.7%) with a statistically Significant difference as (P< 0.05). 6.6 % of group A developed wound infection, while 32.2 % had wound infection postoperatively in group B with a statistically significant difference (P< 0.05). Complete surgical failure when wound dehiscence occurs, it was found that no significant difference between the 2 groups (P value=0.1).Conclusions: TIP repair is a versatile operation that can be performed in almost all cases of penile hypospadias. We believe that early stent removal after 1 day of surgery for hypospadias repair simplifies postoperative care, highly reduces risk of development of urethrocutaneous fistula, meatal stenosis and wound infection, so obviates the need for antibiotics.

show abstract

Tubularized Incised Plate Hypospadias Repair for Proximal Hypospadias

Abstract: Tubularized incised plate urethroplasty is a versatile operation that corrects proximal hypospadias defects with few complications and superior cosmetic results.

Cited by 241 publications

References 4 publications

Distal hypospadias: which repair?

Distal hypospadias: which repair?

Tubularized incised plate urethroplasty for hypospadias reoperation: a review and meta-analysis

Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

Contact Info

Product

Resources

About