To evaluate the short-term surgical and cosmetic outcome of hypospadias repair using tubularized incised plate urethroplasty (TIPU) with foreskin reconstruction (FSR) in children with distal hypospadias, 50 children with distal hypospadias were categorized according to parental preference either to have TIPU only or to have TIPU with FSR and to be circumcised one-month later. Mothers were trained for the frequent postoperative meatal dilatation and preputial retraction. Patients were followed-up weekly for one-month for the occurrence of complications related to either urethroplasty or FSR. Parents' satisfaction concerning the cosmetic appearance of the penis after FSR and prior to circumcision was inquired. Eleven children had glandular and 39 had coronal hypospadias; 30 children had TIPU and FSR, and 20 children had TIPU only. Five patients (10%); 3 had TIPU only and 2 had TIPU & FSR required redo surgery for repair of urethrocutaneous fistula. Only 3 patients who had FSR developed phimosis but was not hampering meatal dilatation. One patient had FSR gapping and was readmitted for circumcision at 2 weeks after surgery. Two patients in TIPU group required removal of redundant skin. Parents of all patients had FSR were highly satisfied by the appearance of the penis after surgery and liked regaining of its normal anatomical appearance. TIPU and FSR is a simple and safe procedure for distal hypospadias repair with minimal morbidities and a higher satisfaction rate for both children and parents; so, if the objective of distal hypospadias surgery is to restore a penis with an appearance as normal as possible, prepuce reconstruction should constitute a key element of the final result. |
