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S14-11
(P)
HYPOSPADIAS REDO, WHAT TO DO? A COMPARATIVE STUDY BETWEEN TIP
URETHROPLASTY AND SINGLE STAGE DORSAL INLAY BUCCAL MUCOSA GRAFT
WITH TUBULARIZED INCISED URETHRAL PLATE TECHNIQUE FOR COMPLEX
HYPOSPADIAS REOPERATIONS.
Mohamed YASSIN, Diaa ABDELFATAAH, Mahmoud MAHMOUD, Ahmed SAFFAN, Ahmed FAROUK and Mohamed KOTB
AIN SHAMAS UNIVERSITY, UROLOGY, Cairo, EGYPT
PURPOSE
In current practice hypospadias repairs are performed as outpatient procedures with high success rate but treatment of
patients with failed hypospadias repairs can be challenging.
The study was designed to compare the tubularized incised plate (TIP) urethroplasty and single stage dorsal inlay buccal
mucosa graft with tubularized incised plate technique (Snod – graft) for complex hypospadias re-operations.
MATERIAL AND METHODS
Fifty-nine patients with previous 1 – 5 failed hypospadias repair were enrolled in the study, age ranging from 38 months
to 29 years. Complete dehiscence was seen in 40 cases while urethral stricture was seen in 19.
Group 1 included 37 patients TIP procedure was done to all of them and 22 patients in group 2 were operated using
single stage dorsal inlay BMG with tubularized incised plate technique.
RESULTS
Success rate was 86.5% in group 1 with 3 fistulas and 2 urethral strictures, and 90.9% in group 2 with only 1 fistula
and 1 stricture, which were related to the type of primary repair and the number of failed previous repairs.
CONCLUSIONS
Previously failed hypospadias repair continues to be a challenge to the Urologist.
TIP is a satisfactory choice for the repair of failed hypospadias, but can't replace all other hypospadias repair
techniques. There is still no single universally applicable technique for the secondary repair of all failed hypospadias.
And it is nearly inapplicable in cases of severe fibroses and scarred urethral plate.
The single stage dorsal inlay BMG approach combines the excellent cosmetic and functional results of the Snod grass
technique with BMG. Given its simplicity, versatility, and the low complication rate, it's a valuable option for complex
hypospadias reoperations.