Tubularized incised plate urethroplasty: Modification and outcome

Adel A. Al-Hunayan, Elijah O. Kehinde, Mamdouh A. Elsalam, Rola S. Al-Mukhtar

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background/purpose: To review the outcome of tubularized incised plate (TIP) urethroplasty in the primary treatment of penile hypospadias with minimal chordee and to describe our experience with the lateral flap used to cover the urethroplasty. Methods: The charts of all patients with penile hypospadias who underwent primary TIP repair in our hospital between 1996 and 2001 were examined and pre as well as postoperative biodata were recorded. We used the lateral flap to cover the repair rather than a flap harvested from preputual skin as in the original description. Results: 94 patients were identified but only 83 were suitable for analysis. The mean age of the evaluable patients was 2.67 years (range 1-10). The mean of follow-up was 17.49 months (range 1-54). The preoperative meatal position was coronal in 50 (60.2%), distal shaft in 28 (33.7%) and mid shaft in 5 (6.1%) patients. The mean length of the urethral plate was 8 mm (range 5-15) while the mean width of the plate was 6 mm (range 4-8). In 30 patients (36.14%) chordee was present preoperatively. All patients were admitted to the hospital following the TIP urethroplasty with a urethral stent in place. The lateral flap was used to cover the repair in 70 patients. The stent was left for an average of 7.83 days (7-10). The average hospital stay was 8.83 days (7-11). A cosmetically normal vertically oriented slit-like meatus was seen in 78 (94%) patients. The TIP repair revealed an apical meatus in 82 (98.8%) and a conical glanular configuration in 79 (95.20%) patients. The parents observed that the urinary stream and the penile shaft were straight in 75 (90.4%) and 82 (98.8%) patients respectively. Seven patients (8.4%) developed meatal stenosis requiring repeated dilatations; four patients (4.8%) developed urethrocutaneous fistula and one (1.2%) had postoperative bleeding requiring transfusion. Of the 70 patients who had the lateral flap, 3 (4.28%) developed urethrocutaneous fistula. Conclusion: Our experience indicates that the TIP repair gives a good cosmetic and functional outcome with minimal complications. Urethroplasty coverage using the lateral flap is associated with a low incidence of urethrocutaneous fistulae.

Original languageEnglish
Pages (from-to)47-52
Number of pages6
JournalInternational Urology and Nephrology
Volume35
Issue number1
DOIs
Publication statusPublished - 2003
Externally publishedYes

Fingerprint

Fistula
Hypospadias
Stents
Cosmetics
Dilatation
Length of Stay
Pathologic Constriction
Parents
Hemorrhage
Skin
Incidence
Therapeutics

Keywords

  • Child
  • Hypospadias
  • Penis
  • Surgery
  • Urethra

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Nephrology
  • Urology

Cite this

Al-Hunayan, A. A., Kehinde, E. O., Elsalam, M. A., & Al-Mukhtar, R. S. (2003). Tubularized incised plate urethroplasty: Modification and outcome. International Urology and Nephrology, 35(1), 47-52. https://doi.org/10.1023/A:1025995811691

Tubularized incised plate urethroplasty : Modification and outcome. / Al-Hunayan, Adel A.; Kehinde, Elijah O.; Elsalam, Mamdouh A.; Al-Mukhtar, Rola S.

In: International Urology and Nephrology, Vol. 35, No. 1, 2003, p. 47-52.

Research output: Contribution to journalArticle

Al-Hunayan, AA, Kehinde, EO, Elsalam, MA & Al-Mukhtar, RS 2003, 'Tubularized incised plate urethroplasty: Modification and outcome', International Urology and Nephrology, vol. 35, no. 1, pp. 47-52. https://doi.org/10.1023/A:1025995811691
Al-Hunayan, Adel A. ; Kehinde, Elijah O. ; Elsalam, Mamdouh A. ; Al-Mukhtar, Rola S. / Tubularized incised plate urethroplasty : Modification and outcome. In: International Urology and Nephrology. 2003 ; Vol. 35, No. 1. pp. 47-52.
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abstract = "Background/purpose: To review the outcome of tubularized incised plate (TIP) urethroplasty in the primary treatment of penile hypospadias with minimal chordee and to describe our experience with the lateral flap used to cover the urethroplasty. Methods: The charts of all patients with penile hypospadias who underwent primary TIP repair in our hospital between 1996 and 2001 were examined and pre as well as postoperative biodata were recorded. We used the lateral flap to cover the repair rather than a flap harvested from preputual skin as in the original description. Results: 94 patients were identified but only 83 were suitable for analysis. The mean age of the evaluable patients was 2.67 years (range 1-10). The mean of follow-up was 17.49 months (range 1-54). The preoperative meatal position was coronal in 50 (60.2{\%}), distal shaft in 28 (33.7{\%}) and mid shaft in 5 (6.1{\%}) patients. The mean length of the urethral plate was 8 mm (range 5-15) while the mean width of the plate was 6 mm (range 4-8). In 30 patients (36.14{\%}) chordee was present preoperatively. All patients were admitted to the hospital following the TIP urethroplasty with a urethral stent in place. The lateral flap was used to cover the repair in 70 patients. The stent was left for an average of 7.83 days (7-10). The average hospital stay was 8.83 days (7-11). A cosmetically normal vertically oriented slit-like meatus was seen in 78 (94{\%}) patients. The TIP repair revealed an apical meatus in 82 (98.8{\%}) and a conical glanular configuration in 79 (95.20{\%}) patients. The parents observed that the urinary stream and the penile shaft were straight in 75 (90.4{\%}) and 82 (98.8{\%}) patients respectively. Seven patients (8.4{\%}) developed meatal stenosis requiring repeated dilatations; four patients (4.8{\%}) developed urethrocutaneous fistula and one (1.2{\%}) had postoperative bleeding requiring transfusion. Of the 70 patients who had the lateral flap, 3 (4.28{\%}) developed urethrocutaneous fistula. Conclusion: Our experience indicates that the TIP repair gives a good cosmetic and functional outcome with minimal complications. Urethroplasty coverage using the lateral flap is associated with a low incidence of urethrocutaneous fistulae.",
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