COMPARATIVE STUDY BETWEEN TUBULARIZED INCISED PLATE URETHROPLASTY AND DISTALLY FOLDED ONLAY FLAP IN TREATMENT OF ANTERIOR HYPOSPADIAS

Abstract

Introduction & Objectives: Hypospadias is one of the commonest congenital anomalies. The only treatment of hypospadias is surgical repair of the anatomical defect. Tubularized incised plate urethroplasty (TIPU) is currently accepted as the procedure of choice for distal hypospadias repair. The onlay island flap urethroplasty has found application in a wide variety of hypospadic conditions because it is straight forward, reliable and provides excellent results. The aim of our study is to make a comparative study between tubularized incised plate urethroplasty and distally folded onlay flap in treatment of anterior hypospadias. Material & Methods: This prospective study was carried out at Urology Department Zagazig University from April 2009 to December 2011. It included 50 patients with anterior hypospadias (coronal, subcoronal or distal penile), either primary or recurrent cases. Patients were randomly allocated into two groups, the 1st group [group A] included 25 patients operated with TIP urethroplasty, and the 2nd one [group B] included 25 patients operated with distally folded onlay flap urethroplasty. Results: The mean age was 6 years for group A and 6 years and 6 months for group B. The mean operative time was 70 minutes and 90 minutes in primary cases for group A and group B respectively, while it was 87.5 minutes and 105 minutes in recurrent cases for group A and group B respectively. The overall reoperation rate either for early or late complications was 8/25 (32%) in group A and 5/25 (20%) in group B. Conclusions: TIP urethroplasty is a standard technique for repair of distal penile hypospadias however distally folded onlay flap urethroplasty is an alternative option with lower complication rate and better cosmotic appearance especially in cases with small glans size. Keywords: TIPU, distally folded onlay flap