Background: To compare the outcomes between classic tubularized incised plate (C-TIP), known as Snodgrass urethroplasty,
and grafted TIP (G-TIP) in the repair of primary distal penile hypospadias.
Methods: Parents of all children presented to our tertiary care institution with primary distal penile hypospadias
were asked to participate in this study. Patients were equally randomized using closed envelope method into two
groups; Group A underwent repair using G-TIP and Group B underwent repair using the C-TIP. Circumcised cases
and/or cases with penile chordee > 30 degrees were excluded from this study. Urethral catheter was kept for 7 to
10 days after surgery. The success rate and cosmetic outcomes assessed by HOSE score were evaluated at 6-month
postoperatively.
Results: A total of 55 patients were recruited in each group. One hundred and seven patients of the 110 patients (54
and 53 in groups A and B, respectively) were evaluated at 6-month postoperatively using HOSE score. All preoperative
data were comparable in both groups. Success was documented in 49/54 patients (90.7%) in group A. The five failures
were secondary to two cases of glans dehiscence and three cases of residual postoperative chordee. Whereas, success
was documented in 48/53 patients (90.5%) in group B. Complications were: a case of meatal stenosis, three cases of
fistula, and a case of combined meatal stenosis and fistula. The HOSE score was comparable between the two groups
(15.4 ± 1.09 vs. 15.6 ± 0.55; p = 0.29). However, the operative time was statistically longer in the G-TIP compared with
the C-TIP (91.4 ± 6.2 min vs. 85.2 ± 6.3 min; p < 0.001), respectively.
Conclusion: The G-TIP urethroplasty provided comparable results with C-TIP in terms of cosmoses, success rate, and
complications. However, G-TIP was accompanied with significantly longer operative time. |
