Subscribe to RSS
DOI: 10.1055/s-0030-1270457
© Georg Thieme Verlag KG Stuttgart · New York
Stent-Free Tubularized Incised Plate (TIP) Repair of Distal and Mid-Shaft Hypospadias Irrespective of Age
Publication History
received November 08, 2010
accepted after revision November 20, 2010
Publication Date:
31 January 2011 (online)

Abstract
Purpose: Aim of this study was to report our experiences with tubularized incised plate (TIP) repair without placement of a postoperative urethral stent in 41 cases.
Patients and Methods: Since October 2005, we have performed TIP repair for distal penile hypospadias without using a postoperative urethral stent. A urethral stent is used intraoperatively for the tubularization of the neourethra and is removed at the end of the procedure. Follow-up included clinical examination and a structured telephone interview on parental satisfaction.
Results: The group included 41 boys, 60% with coronal or distal hypospadias and 40% with mid-shaft hypospadias (aged 6 months to 16 years, median: 3 years). In 7 cases, the prepuce was also reconstructed. There were 2 cases with fistula and one case of meatal stenosis. No glans dehiscence, severe bleeding, or wound infection was observed. No urinary retention requiring catheterization was observed, irrespective of age. All but one patient was discharged the day after surgery. Follow-up ranged from 8 to 48 months (average: 22 months). Most parents (87.5%) were satisfied or very satisfied.
Conclusion: Based on our preliminary experiences, patient comfort and safety, parental satisfaction and the rate of complications seem to be promising with this technique.
Key words
hypospadias - stent - stent-free - TIP
References
- 1
Mathieu P.
Traitement en un temps de l’hypospadias balanique ou juxtabalanique.
J Chir.
1932;
39
481-487
Reference Ris Wihthout Link
- 2
Snodgrass W.
Tubularized, incised plate urethroplasty for distal hypospadias.
J Urol.
1994;
151
464-465
Reference Ris Wihthout Link
- 3
Leclair MD, Camby C, Battisti S. et al .
Unstented tubularized incised plate urethroplasty combined with foreskin reconstruction
for distal hypospadias.
Eur Urol.
2004;
46
(4)
526-530
Reference Ris Wihthout Link
- 4
Samuel M, Capps S, Worthy A.
Distal hypospadias: which repair?.
BJU Int.
2002;
90
(1)
88-91
Reference Ris Wihthout Link
- 5
Rabinowitz R.
Outpatient catheterless modified Mathieu hypospadias repair.
J Urol.
1987;
138
1074-1076
Reference Ris Wihthout Link
- 6
Almodhen F, Alzahrani A, Jednak R. et al .
Nonstented tubularized incised plate urethroplasty with Y-to-I spongioplasty in non-toilet
trained children.
Can Urol Assoc J.
2008;
2
(2)
110-114
Reference Ris Wihthout Link
- 7
Hakim S, Merguerian PA, Rabinowitz R. et al .
Outcome analysis of the modified Mathieu hypospadias repair: comparison of stented
and unstented repairs.
J Urol.
1996;
156
836-838
Reference Ris Wihthout Link
- 8
Minevich E, Pecha BR, Wacksman J. et al .
Mathieu hypospadias repair: experience in 202 patients.
J Urol.
1999;
162
(6)
2141-2142
discussion 2142–2143
Reference Ris Wihthout Link
- 9
Buson H, Smiley D, Reinberg Y. et al .
Distal hypospadias repair without stents: is it better?.
J Urol.
1994;
151
(4)
1059-1060
Reference Ris Wihthout Link
- 10
El-Sherbiny MT.
Tubularized incised plate repair of distal hypospadias in toilet-trained children:
should a stent be left?.
BJU Int.
2003;
92
(9)
1003-1005
Reference Ris Wihthout Link
- 11
Hafez AT, Herz D, Bägli D. et al .
Healing of unstented tubularized incised plate urethroplasty: an experimental study
in a rabbit model.
BJU Int.
2003;
91
(1)
84-88
Reference Ris Wihthout Link
- 12
Lorenz C, Schmedding A, Leutner A. et al .
Prolonged stenting does not prevent obstruction after TIP repair when the glans was
deeply incised.
Eur J Pediatr Surg.
2004;
14
(5)
322-327
Reference Ris Wihthout Link
- 13
Akbiyik F, Tiryaki T, Senel E. et al .
Clinical experience in hypospadias: results of tubularized incised plate in 496 patients.
Urology.
2009;
73
(6)
1255-1257
Reference Ris Wihthout Link
- 14
Snodgrass WT, Bush N, Cost N.
Tubularized incised plate hypospadias repair for distal hypospadias.
J Pediatr Urol.
2010;
6
(4)
408-413
Reference Ris Wihthout Link
- 15
Braga LH, Lorenzo AJ, Salle JL.
Tubularized incised plate urethroplasty for distal hypospadias: A literature review.
Indian J Urol.
2008;
24
(2)
219-225
Reference Ris Wihthout Link
- 16
Hardwicke J, Jones E, Wilson-Jones N.
Optimization of silicone urinary catheters for hypospadias repair.
J Pediatr Urol.
2010;
6
(4)
385-388
Reference Ris Wihthout Link
- 17
Aslan AR, Yücebaş E, Tekin A. et al .
Short-term catheterization after TIP repair in distal hypospadias: who are the best
candidates?.
Pediatr Surg Int.
2007;
23
(3)
265-269
Reference Ris Wihthout Link
- 18
Mustafa NA, Lope RJ, Cheah FC.
Spontaneous knot formation impeding the removal of a silicone urethral catheter.
Arch Dis Child Fetal Neonatal Ed.
2006;
91
(4)
F287
Reference Ris Wihthout Link
- 19
Lodha A, Ly L, Brindle M. et al .
Intraurethral knot in a very-low-birth-weight infant: radiological recognition, surgical
management and prevention.
Pediatr Radiol.
2005;
35
(7)
713-716
Reference Ris Wihthout Link
- 20
Mayer E, Ankem MK, Hartanto VH. et al .
Management of urethral catheter knot in a neonate.
Can J Urol.
2002;
9
(5)
1649-1650
Reference Ris Wihthout Link
- 21
Al-Shammari A, Bhatti A, Kupchak J. et al .
Ureteroneocystostomy with and without the use of an intravesical catheter.
Can J Urol.
1999;
6
(4)
844-849
Reference Ris Wihthout Link
Correspondence
Dr. Salmai TurialMD
University Medical Center
Department of Pediatric
Surgery
Langenbeckstr. 1
55101 Mainz
Germany
Phone: +49 6131 177 107
Fax: +49 6131 176 523
Email: salmai.turial@unimedizin-Mainz.de