Tubularized incised plate urethroplasty: 5 years' experience.

OBJECTIVE: To evaluate the results of tubularized incised plate (TIP) urethroplasty in a series of primary hypospadias repairs.

PATIENTS AND METHOD: The medical records of 360 children (Mean age: 4.3 years, range: 2-14 years) with primary hypospadias undergoing TIP urethroplasty repair and treatment of complications were reviewed. A good result is a direct urinary steam through a slit and vertically oriented meatus and mild angled urinary stream through a slightly regressed meatus is a satisfactory result.

RESULTS: The sum of good (74%) and satisfactory results (3%) was the overall success rate (77%) which was increased to 95% after a second surgical procedure for the treatment of complications. In 30 patients with single fistula (8%), fistula healed spontaneously in 2 patients and 20 patients had successful fistula closure. Redo TIP urethroplasty (n = 30) was performed for dehiscence (n = 15, 3%), neourethral stricture (n = 3, 1%) and multiple fistula with meatal stenosis (n = 12, 3%). The complication rate after redo TIP urethroplasty is 30%. Twenty-four (7%) patients underwent meatoplasty for meatal stenosis.

CONCLUSION: TIP urethroplasty can be used to repair primary hypospadias. After a learning curve and attention to surgical details, cosmetic and functional outcome become excellent. Redo TIP urethroplasty can be performed in the treatment of complications.