Téma: 

Tubularised incised plate technique in hypospadias repair

Kamil Javorka, Ján Kliment jr., Juraj Svitač

Objective: Tubularized incised plate (TIP) was first described in 1994 by Snodgrass and today is very popular. The aim of hypospadias surgery is to achieve a normal function and cosmetical appearance of penis. The aim of our retrospective study was to summarize our experience with this method.
Material and methods: We analyzed retrospectively 42 patients (age 18 months - 29 years, follow-up 1 month - 4 years ) with hypospadias after TIP between january 2002 to march 2006 (40 primary surgery, 2 reoperations). 39 patients with distal hypospadia, 3 patients with proximal form of hypospadia and 1 patient with urethrocutaneous fistula after previous operation underwent TIP. The dartos flap graft was used to overlap neourethra in 32 (76,2 %) patients. Silicone urethral stent was used in 36 (92,8 %) patients, derivation by suprapubic tube remained for a period of 12 - 14 days. Silicone urethral catheter was used in 3 (7,2 %) patients. Dilatation of neourethra was necessary in 4 (9,5 %) patients during 1 to 4 weeks. Straightening of penis was necessary in 6 patients (14,3 %).
Results: Surgery without complications was in 28 (66,6 %), urethrocutaneous fistula occured in 11 (26,2 %), meatal stenosis in 3 (7,2 %) patients. The succesfull oclusion of urethocutaneous fistlula was perform in 3 patients 12 to 14 months after primary surgery. Meatal stenosis in 3 patients was resolved by ventral meatotomy 6 months after surgery.
Conclusion: TIP offers very good cosmetical and functional results, simultaneous usage of tunica dartos flap can minimalize complications after surgery.

Ročník 2006  Témy časopisu Clinical urology 1 / 2006

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