Role of the urethral plate characters in the success of tubularized incised plate urethroplasty
Background: Today, tubularized incised plate (TIP) urethroplasty is the most commonly performed operation for distal and mid-penile hypospadias. Reports from different centers worldwide confirm its nearly universal applicability and low complications rate. Aim: Evaluation of the urethral plate chara...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2014-05-01
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| Series: | Indian Journal of Plastic Surgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.138956 |
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| author | Hamdy Aboutaleb |
| author_facet | Hamdy Aboutaleb |
| author_sort | Hamdy Aboutaleb |
| collection | DOAJ |
| description | Background: Today, tubularized incised plate (TIP) urethroplasty is the most commonly performed operation for distal and mid-penile hypospadias. Reports from different centers worldwide confirm its nearly universal applicability and low complications rate. Aim: Evaluation of the urethral plate characters and its effect on the outcome of TIP urethroplasty. Materials and Methods: Between 2010 and 2013, 100 children with primary distal penile hypospadias underwent TIP urethroplasty. Urethral plates were categorized as flat, cleft, and deeply grooved. Postoperatively, patients were followed-up for evaluation of meatal stenosis, fistula formation, and glandular dehiscence at 1 st , 3 rd and 6 th months. Patients were followed-up for urethral calibration by urethral sound 8 Fr at 3 rd and 6 months follow-up. Data were statistically analysed using Epi info program to correlate between the width, plate shape, and complications. Results: Mean age at surgery was 4.3 years. Patients were followed-up for an average period of 6.4 months. Pre-operative location of the meatus was reported as coronal in 46, subcoronal in 50 and anterior penile in 4 cases. Urethral plate characters were flat in 26 cases, cleft in 52, and deeply grooved in 22. Urethral plate width was >8 mm in 74 cases and <8 mm in 26. Patients with urethral plate <8 mm had a statistically significant higher fistula rate (P = 0.004) and failed 8 Fr calibrations in 26.9% (P = 0.01) compared with the patients with urethral plate >8 mm. In addition, we also founds higher fistula rate and failed 8 Fr calibrations in flat urethral plate. Conclusions: An adequate urethral plate width (>8 mm) is essential for successful TIP repair. Lower success rates with flat plates may need buccal mucosal augmentation to improve the results. |
| format | Article |
| id | doaj-art-44bbf0f6ecaf451fa2a89d1b048b25b9 |
| institution | Kabale University |
| issn | 0970-0358 1998-376X |
| language | English |
| publishDate | 2014-05-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Plastic Surgery |
| spelling | doaj-art-44bbf0f6ecaf451fa2a89d1b048b25b92025-08-20T03:36:44ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2014-05-01470222123710.4103/0970-0358.138956Role of the urethral plate characters in the success of tubularized incised plate urethroplastyHamdy Aboutaleb0Departments of Urology, Minoufiya University Hospitals, EgyptBackground: Today, tubularized incised plate (TIP) urethroplasty is the most commonly performed operation for distal and mid-penile hypospadias. Reports from different centers worldwide confirm its nearly universal applicability and low complications rate. Aim: Evaluation of the urethral plate characters and its effect on the outcome of TIP urethroplasty. Materials and Methods: Between 2010 and 2013, 100 children with primary distal penile hypospadias underwent TIP urethroplasty. Urethral plates were categorized as flat, cleft, and deeply grooved. Postoperatively, patients were followed-up for evaluation of meatal stenosis, fistula formation, and glandular dehiscence at 1 st , 3 rd and 6 th months. Patients were followed-up for urethral calibration by urethral sound 8 Fr at 3 rd and 6 months follow-up. Data were statistically analysed using Epi info program to correlate between the width, plate shape, and complications. Results: Mean age at surgery was 4.3 years. Patients were followed-up for an average period of 6.4 months. Pre-operative location of the meatus was reported as coronal in 46, subcoronal in 50 and anterior penile in 4 cases. Urethral plate characters were flat in 26 cases, cleft in 52, and deeply grooved in 22. Urethral plate width was >8 mm in 74 cases and <8 mm in 26. Patients with urethral plate <8 mm had a statistically significant higher fistula rate (P = 0.004) and failed 8 Fr calibrations in 26.9% (P = 0.01) compared with the patients with urethral plate >8 mm. In addition, we also founds higher fistula rate and failed 8 Fr calibrations in flat urethral plate. Conclusions: An adequate urethral plate width (>8 mm) is essential for successful TIP repair. Lower success rates with flat plates may need buccal mucosal augmentation to improve the results.http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.138956hypospadiastubularized incised plateurethra |
| spellingShingle | Hamdy Aboutaleb Role of the urethral plate characters in the success of tubularized incised plate urethroplasty Indian Journal of Plastic Surgery hypospadias tubularized incised plate urethra |
| title | Role of the urethral plate characters in the success of tubularized incised plate urethroplasty |
| title_full | Role of the urethral plate characters in the success of tubularized incised plate urethroplasty |
| title_fullStr | Role of the urethral plate characters in the success of tubularized incised plate urethroplasty |
| title_full_unstemmed | Role of the urethral plate characters in the success of tubularized incised plate urethroplasty |
| title_short | Role of the urethral plate characters in the success of tubularized incised plate urethroplasty |
| title_sort | role of the urethral plate characters in the success of tubularized incised plate urethroplasty |
| topic | hypospadias tubularized incised plate urethra |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.138956 |
| work_keys_str_mv | AT hamdyaboutaleb roleoftheurethralplatecharactersinthesuccessoftubularizedincisedplateurethroplasty |