Tubularized proximally-incised plate in distal/midshaft hypospadis repair

Objective: The aim of this study was toto verify the validity and the feasibility and the functional results, by uroflowmetry, of Tubularized Proximally –IncisedPlatetechnique in selected case of distal/midshaft hypospadias. Materials and Methods: Twenty-three patients were selected out of 120 pts scheduled to undergoTubularized Incised Plate(TIP-Snodgrass) procedure between January 2013 and January 2016 (19.1%). This case series comprised 16 patients with distal and 7 with midshaft hypospadias. Mean age at surgery was 2.9 yrs. The inclusion criteria were a deep and wide glandular groove and a proximal narrow urethral plate.The procedure was carried out as described by Snodgrass but the incision of the urethral plate, including the mucosal and submucosal tissue, was made only proximally, between the original meatus and the glandular groove in no case extending to the entire length of the plate. Postoperatively a foley catheter was left in place from 4 to 7 days. Uroflowmetry was performed when the patients age ranged from 2.5 to 5.7 years (mean age 3.11 years and mean follow-up 1.8 yrs, body surface < 1.1m2). Patients were included if they were old enough to void volitionally and fistula- free. The results of flow pattern were expressed as percentiles and compared with those reported by Toguri (7) At the time of uroflowmetry their ages ranged from 2.5 to 5.7 years (mean age 3.11 years and mean follow-up 1.8 yrs, body surface < 1.1m2). Results: No patients presented fistulas nor perioperative complications. At uroflowmetry eighteen patients presented values above the 25th percentileand 5 showed a borderline flow. All patients in this group,remained stable without urinary symptoms. Conclusions:In selected cases, the tubularized proximally-incised plate yields satisfactory cosmetic and functional results for the treatment of midshaft proximal hypospadias. A long- term follow-up study is needed for further evaluation. Patient selection is crucial for the success of this technique