Modified tubularized incised plate urethroplasty for hypospadias repair: a long-term results of 764 patients.

Objectives: To present our experience with a modification of tubularized incised plate (TIP) urethroplasty for treatment of anterior penile hypospadias.

Methods: A total of 764 children with primary anterior penile hypospadias (462 subcoronal and 302 coronal) underwent hypospadias repair by using modified TIP urethroplasty. The technique involves, in addition to the standard TIP, the use of the dorsal prepuce which was divided in 2 flaps. The right flap was de-epithelialized on both the outer and inner sides and transferred as interposing layer between the neourethra and the coverings. The left flap was de-epithelialized on the inner side and transferred ventrally as skin coverage. The follow-up ranged between 3 and 52 months with a mean of 17 months.

Results: Excellent functional and cosmetic results were achieved in 738 patients (96.6%). Urethral fistulae were encountered in 16 cases (2%) and were repaired successfully. Meatal stenosis was noted in 8 cases (1%) and successfully treated. Two patients had complete disruption of the wound (0.2%), which was corrected.

Conclusions: Excellent functional and cosmetic results can be achieved after repair of anterior penile hypospadias by using TIP urethroplasty with the modification of using double breasted de-epithelialized skin flap.