Comparative Study between the Tubularized Incised Plate Urethroplasty and Single Faced Onlay Preputial Island Flap in the Management of Mid-Penile Hypospadias

Background/Purpose: The tubularized incised plate (TIP) and the single faced Onlay preputial island flap procedures are two popular procedures used for the repair of mid-penile hypospadias deformity. This study was designed to compare these two techniques objectively. Materials and Methods: Forty five boys with similar mid-penile hypospadias deformities were selected for this study at Cairo University Children Hospital. All were 2 years or more at the time of operation. They were assigned randomly to either a TIP (n=24) or an Onlay procedure (n=21). Operative details for each patient were recorded and the patients were followed up for a minimum of one year post operatively.Results were compared for three groups of variables: cosmetic outcome, occurrence of complications and function results which was assessed by uroflowmetry studies. Results were compiled and compared statistically. Results: There were no differences between the two techniques as regard incidence of complications and function. On the other hand there was a significant statistical difference regarding cosmetic outcome in favor for the TIP procedure. Due to its easier technique and superior cosmetic results, the authors believe it is indicated whenever suitable urethral plate is present. Conclusion: Both the TIP and Onlay procedures proved to be effective techniques in the management of mid penile hypospadias. However, due to a significantly better cosmetic results and easier technicality of TIP the authors believes it is indicated whenever the suitable urethral plate is available.