ABSTRACT
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.
KEY WORDS
Hypospadias - tubularized incised plate - urethra
