Re-operative Hypospadias Repair Using Tubularized Incised Plate Urethroplasty

Tanta University15 enrolled

Overview

The aim of this study is to evaluate the outcomes, feasibility, and complication profile of re-operative hypospadias repair using tubularized incised plate urethroplasty as a single-stage procedure in a single-center experience.

Hypospadias repair remains one of the most common reconstructive procedures in pediatric urology; however, re-operative hypospadias represents a challenging subset due to distorted anatomy, urethral plate scarring, deficient local tissues, and higher complication rates compared with primary repairs. The tubularized incised plate (TIP) urethroplasty, originally described by Snodgrass, revolutionized primary hypospadias repair and has since been adapted for selected reoperative cases. Contemporary evidence suggests that despite prior surgery and scary, a well-vascularized urethral plate of adequate width can still be successfully tubularized following a midline relaxing incision, offering acceptable functional and cosmetic outcomes.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Re-operative Hypospadias Tubularized Incised Plate Urethroplasty

Interventions

Tubularized Incised Plate UrethroplastyPROCEDURE

All procedures were performed under general anesthesia using the tubularized incised plate technique. After completing penile degloving and exposure of the urethral plate, a midline longitudinal incision was made along the entire length of the plate to allow tension-free tubularization. The urethral plate was then tubularized over an appropriate-sized urethral catheter using fine absorbable sutures. A well-vascularized dartos flap was harvested and interposed as a protective layer over the neourethra, followed by meticulous skin closure.

Eligibility

Sex: ALLMin age: 1 YearMax age: 16 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Both sexes. * Children with recurrent or residual hypospadias in whom the urethral plate is deemed suitable for reuse, defined as a plate width of at least 8-9 mm with acceptable vascularity and without severe fibrosis. Exclusion Criteria: * Patients with severely scared or fibrotic urethral plates are not suitable for tubularization. * Absent or destroyed urethral plates following previous failed hypospadias repairs. * Patients require staged urethral reconstruction rather than a single-stage procedure. * Presence of poor urethral plate vascularity or ischemic tissue. * Extensive penile scarring or fibrosis resulting from multiple previous surgical attempts. * Severe penile curvature requiring excision of the urethral plate. * Inability to achieve adequate, well-vascularized tissue coverage over the neourethra.

Locations (1)

Tanta University

Tanta, El-Gharbia, Egypt

Outcomes

Primary Outcomes

Success rate

The success rate of tubularized incised plate urethroplasty reoperation after treatment was recorded.

Time frame: 6 months after the procedure

Secondary Outcomes

Incidence of complications

Incidence of postoperative complications such as fistula, meatal stenosis, glans dehiscence, and urethral stricture were recorded.

Time frame: 6 months after the procedure

Incidence of postoperative urethrocutaneous fistula

Incidence of postoperative urethrocutaneous fistula was recorded.

Time frame: 6 months after the procedure

Incidence of meatal stenosis

Incidence of meatal stenosis was recorded.

Time frame: 6 months after the procedure

Data from ClinicalTrials.gov

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