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Prof. Ahmed Mahmoud Ahmed El-Adl :: Publications:

Title:
Extended TIP vs. Standard TIP: Do Pre-operative Parameters Affect Functional and Cosmetic Outcomes? Randomized Prospective Study
Authors: Ahmed Mahmoud Al Adl; Yasser A Noureldin; Ashraf Mohamed Abdel Aal; Tarek Mohamed Gharib; Kareem Ali El Attar and Tarek Mohammed El Karamany
Year: 2019
Keywords: Hypospadias; Tubularized Incised Plate; Technique; Evaluation.
Journal: the 35th Annual EAU Congress Amsterdam (EAU20)
Volume: Not Available
Issue: Not Available
Pages: Not Available
Publisher: European Urology Supplements
Local/International: International
Paper Link:
Full paper Ahmed Mahmoud Ahmed El-Adl_Extended TIP vs. Standard TIP Do Pre-operative Parameters-.pdf
Supplementary materials Not Available
Abstract:

Introduction & Objectives: To objectively compare functional and cosmetic outcomes between the extended Tabularized Incised Plate (e-TIP) and standard TIP (s-TIP) techniques and assess the impact of pre-operative parameters on these outcomes between both techniques. Materials & Methods: In this randomized prospective study, 110 patients with primary distal hypospadias recruited from outpatient clinic of our university hospital between June 2015 and January 2019. These patients were randomized to undergo either e-TIP (Group A) or s-TIP (Group B). Group A was repaired with e-TIP where the midline relaxing incision of the urethral plate (UP) was extended beyond its distal end to the very tip of the glans. The UP is tubularized beginning distally at the neomeatus after having made an adequate diameter, so the creation of the meatus precedes tabularization. The cosmetic outcome was objectively evaluated using HOPE score and proportional relationship between meatal length (ML) and ventral glans closure length (VGCL). The functional outcome was assessed by post-voiding residual (PVR), and uroflowmetry. The effect of pre-operative parameters on the outcomes was assessed by regression analysis. Results: Out of 110 randomized, 94 cases were available for analysis, 46 in e-TIP group and 48 cases in s-TIP group. There were no significant differences between both groups in terms of age, meatal location, Glans shape, maximal transverse glanular diameter (TGDmax), and urethral plate (UP) width (p=0.18; p=0.59; p=0.31, p=0.37; p=0.66), respectively. Regarding functional assessment, there were no significant differences between both groups in terms of the uroflow patterns (p=0.99), and Q-max (p=0.49). Regarding cosmetic outcome, there was postoperative higher median (range) of HOPE score in e-TIP 57(45–60) vs. s-TIP 55(44–60), (p

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