THE IMPORTANCE OF URETHRAL PLATE IN HYPOSPADIAS SURGERY AND TUBULARISED INCISED PLATE URETHROPLASTY (TIPU)

Introduction: The approach to hypospadias surgery has changed over the past ten years since the identification of the urethral plate as an anatomical entity. A number of surgical procedures have been described using the urethral plate to correct coronal, distal-middle and proximal shaft hypospadias. Thiersch-Duplay, the glans approximation procedure (GAP) and pyramid repair all involve simple tubularization of the deep glandular cleft and the deeply grooved urethral plate. Most of the time, the ventral glans and urethral plate do not have a groove deep enough for simple tubularisation of the urethral plate. The tubularised incised plate urethroplasty (TIPU) procedure is described for such cases to correct the defect without using additional skin flaps. The final appearance is a vertically oriented, slit-like meatus with excellent cosmetic results and very few complications. Nowadays TIPU is the preferred method for correcting many of the hypospadias cases, even for the very proximal and re-do ones. A brief review about the technique, tricks, complications and the results of the procedure is presented.