ABSTRACT
Background and Aim : Numerous ingenious methods have been introduced to repair hypospadias with variable
results. we tried to evaluate the two techniques, tubularized incised plate urethroplasty
(tip) and anterior urethral advancement (aua) for repair of distal hypospadias and
choose the best method to treat the distal type of penile hypospadias with the least
complications.Materials and methods :A total of 140 boys with distal penile hypospadias were divided into two groups.
group a (68 patients) was treated with tip and group b (72 patients) was treated with
aua. all the patients had an average age of three years (2-19) with variable meatal
sites coronal (44) sub coronal (53) and anterior penile hypospadias (43). there was
no significant difference between both groups with respect to the age and meatal sites.Results : The fistula rate in group a was 8.8% versus 1.3% in group b. there was no urethral
stricture in both procedures. wound dehiscence did not occur in group a versus one
case in group b (1.3%). in group a, 26 cases (38.3%) had mild glanular torsion and
five (7.3%) had moderate glanular torsion versus none in group b postoperatively.
no postoperative chordee or binding in group a, versus four patients (5.5%) in group
b. no significant difference was observed in both groups with respect to meatal stenosis
(7.3% versus 5.5% respectively). there was a significant difference between both groups
with regard to the operative time in favour of group b. good cosmetic appearance of
the glans was achieved in both techniques.Conclusion : Both techniques can treat this anomaly with a high success rate but the modified
aua technique appears to be a good choice due to its simplicity, short operative time
and less fistula rate with good cosmetic results.
KEY WORDS Advancement - choice - hypospadias - urethra
