Tubularized incised-plate urethroplasty for distal and proximal hypospadias

OBJECTIVE To describe the tubularized incised-plate ( TIP) urethroplasty for distal and proximal hypospadias. PATIENTS AND METHODS TIP urethroplasty was undertaken in 83 consecutive boys ( mean age 14.1 months, SD 7.8) within the past 3 years; 65 ( 78%) had distal and 18 ( 22%) proximal penile hypospadias. This was the primary attempt at hypospadias repair in all children. RESULTS All patients were assessed 7 days after surgery at the time of dressing and catheter removal, and subsequently at a median of 4 months in the clinic, before being discharged. The overall late complication rate was 12% and 10% required a second operation. There was a urethrocutaneous fistula in three (5%) of those with distal and in one of the 18 with proximal penile hypospadias ( P = 0.56). Glans dehiscence in distal hypospadias occurred in one (1%) and three, respectively ( P = 0.01). Secondary surgery for fistula repair and glans closure was successful in all patients. All children void with a single straight urinary stream in a forward direction, and have a normally situated vertical slit-like glanular meatus. CONCLUSIONS TIP urethroplasty is a versatile, simple operation with good cosmetic results, which uses the urethral plate to its maximum potential.