To evaluate the sho.rt-term surgical and cosmetic outcome of hypospadias repair using tubularized incised
plate urethroplasty (TIPV) with foreskin reconstruction (FSR) in children with distal hypospadias, 50
children with distal hypospadias were categorized acc^rding to parental preference either to have TIPV
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 dnd 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..
Keywords: Distal hypospadias, TIPU, Foreskin reconstruction
Kasr El Aini Journal of Surgery VOL, 11 , NO t Jaunary 2010 51 |
