Hazim R Akal
FICMS(Urol), Lecturer, Dept.of surgery, Medical College, Thiqar University
Reoperation for failed hypospadias has been considered to be seriously bothersome because abundant penile skin doesn’t tend to remain for urethroplasty or for penile shaft skin coverage. in this study, the tubularization of incised urethral plate was employed for those who had no excessive penile skin after failure of hypospadias repair.
Between June 2003 and February 2006, 18 boys, (4.5-18) years old, underwent tubularized Incised-Plate (TIP) for previously failed hypospadias repair. The hypospadias defects included 9 (50%) distal (coronal or subcoronal), 5 (27.5%) distal penile and 4 (22.2%) mid shaft defects (three of them have residual chordee),13 patients had one operation and 5 had two operation previously. all patients did not have foreskin because of the previous surgery. There was not apparent scarring of the plate.
The operation was successful in eleven out of 13 (84.5%) patients who had undergo one operation before and 3 out of 5 (60%) of patients with 2 operation previously as well have sufficient outcome. Complication was observed in 4 patient.
The absence of preputial skin in reoperative cases makes tubularized incised-plate urethroplasty the ideal operation. In addition, this procedure can give excellent functional and cosmetic results however the patients require revisional hypospadias surgery. The technique has few complications as well as proved success and versatility that continue to expand its applicability and popularity.