The most preferable method for distal hypospadias surgery: TIPU Technique

Abstract

The purpose of this study is to demonstrate the efficiency of tubularized incised-plate urethroplasty (TIPU) method and the complication rates with postoperative early periodical urethral dilatations. Hypospadias is one of the most common congenital anomaly in male genital system. Retrospectively 45 case’s records which had distal hypospadias and undergone surgery were studied in Samsun Obstetrics and Gynecology and Children’s Hospital. The ages of the patients, their meatus locations, cordi existence, suture materials, stenting times, complication incidences after surgery, were evaluated. None of the patients had urethrocutoneous fistule, meatal stenosis, or wound place infection. In all cases, the cosmetic results satisfied both the patient’s family and the doctor. TIPU is the most outstanding treatment alternative in distal hypospadias, when its advantages, such as less complication ratios, perfect cosmetic and funtional results are considered. 

Keywords

• Complication rate
• Hypospadias
• TIPU
• Urethroplasty

References

1. Baskin, L.S., Ebbers, M.B., 2006. Hypospadias: Anatomy, etiology and technique. J. Pediatr. Surg. 41, 463-472.
2. Borer, J.G., Retik, A.B., 1999. Current trends in hypospadias repair. Urol Clin North Am. 26, 15-37.
3. Cooper, C.S., Synder, H.M., 2000. Pediatric reconstructive surgery. Curr Opin Urol. 10, 195-199.
4. Duckett, J.W., Synder, H.M., 1992. MAGPI hypospadias repair after 1000 cases avoidance of meatal stenosis and regression. J. Urol. 147, 6656
5. Ebu-Arafeh, W., Chertin, B., Zilberman, M., 1998. One stage repair of hypospadias: Experience with 856 cases. Eur Urol. 34, 365-367. Elbakry, A., 1999. Tubularized-incised urethral plate urethroplasty: Is regular dilatation necessary for success? BJU Int. 84, 683-688.
6. Hadidi, A.T., Azmy, A.F., 2004. Hypospadias Surgery: An Illustrated Guide. Berlin Heidelberg: Springer-Verlag. 51-163.
7. Kayıkçı, A.M., Çam, K., Akman, R.Y., Erol, A., 2005. The ratio of external genital anomalies in male children attending primary school in Düzce. Turkish Journal Of Urology. 31, 79- 81.
8. Küçükaydın, M., Okur, H., Kazez, A., 1996. Meatal advancement and glanuloplasty (MAGPI) and modified MAGPI experience in 104 patients. Ped. Cer. Derg. 10, 9-12.

9. Oswald, J., Körner, I., Riccabona, M., 2000. Comparison of the perimeatal-based flap (Mathieu) and the tubularized incised-plate urethroplasty (Snodgrass) in primary distal hypospadias. BJU International. 85, 725-727.
10. Park, J.M., Faerber, G.J., Bloom, D.A., 1994. Longterm outcome evaluation of patients outgoing the MAGPI procedure. J Urol. 152, 122912
11. Snodgrass, W., J., 1994. Tubularized, incised plate urethroplasty for primary distal hypospadias. Urology. 151, 464-465.
12. Snodgrass, W., 1999a. Does tubularized incised plate hypospadias repair create neourethral strictures? J Urol. 162, 1159-1161.
13. Snodgrass, W., 1999b. Suture tracks after hypospadias repair. BJU Int. 84, 843-844.
14. Snodgrass, W.T., Shuka, A.R., Canning, D.A. 2007. Hypospadias in In The Kelalis-King-Belman. Docimo, S.G., Canning, D.A., Khoury, A.E. (eds). Textbook of Clinical Pediatric Urology. 5 th ed. Informa healtcare. 71, 1205-1235.
15. Söylet, Y., 2010. Penile abnormalities. Turk. Arch. Ped. 45 Suppl. 94-99.
16. Ulman, I., Erikçi. V., Avanoğlu, A., Gökdemir, A., 1997. The effect of suturing technique and qamaterial on complication rate following hypospadias repair. Eur. J. Pediatr. Surg. 3, 156-157.
17. Uygur, C., Unal, D., Tan, M.O., 2002. Factors affecting outcome of one stage anterior hypospadias repair: Analysis of 422 cases. Pediatr Surg Int. 18, 142-146.
18. Yesildag, E., Tekant, G., Sarımurat, N., Buyukunal, S.N.C., 2004. Do patch procedures prevent complications of the Mathieu technique? J. Urol. 171, 2623-2625.