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Foreskin reconstruction and preservation of a thin distal urethra: a challenge in tubularized incised plate urethroplasty

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Abstract

Purpose

The aim of this retrospective study was to evaluate the functional and cosmetic outcome of tubularized incised plate urethroplasty (TIPU) with preputial reconstruction and preservation of a thin distal urethra when applicable.

Methods

The records of 64 boys with hypospadias, who underwent TIPU between 2000 and 2007 were analyzed. 33 (52%) underwent foreskin reconstruction and a thin distal urethra was preserved and incorporated in 19 (30%) patients. The Hypospadias Objective Scoring Evaluation (HOSE), Pediatric Penile Perception Score (PPPS), and uroflowmetry were evaluated in 55 boys (86%) after a mean of 4.8 years.

Results

All patients had a vertically oriented meatus. The overall rate of fistula occurrence was 9% and of wound dehiscence, 5%. Among 33 preputial reconstructions, two (6%) patients had dehiscence and three (9%) had a fistula. No cases of stricture or stenosis occurred. There were significantly more complications with reconstruction of the foreskin (p = 0.012) and preservation of a thin distal urethra (p = 0.021). Uroflowmetry was normal in 76% of patients. PPPS and HOSE revealed excellent results.

Conclusion

TIPU produces excellent cosmetic and functional results with few complications; complications are more common after foreskin reconstruction and use of a thin distal urethra.

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Abbreviations

TIPU:

Tubularized incised plate urethroplasty

PPPS:

Pediatric Penile Perception Score

HOSE:

Hypospadias Objective Scoring Evaluation

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Authors and Affiliations

  1. General Hospital Klagenfurt, Klagenfurt, Austria

    Gunter Fasching, Christoph Arneitz & Gabriele Gritsch-Olipp

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  1. Gunter Fasching
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  2. Christoph Arneitz
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  3. Gabriele Gritsch-Olipp
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Correspondence to Gunter Fasching.

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Fasching, G., Arneitz, C. & Gritsch-Olipp, G. Foreskin reconstruction and preservation of a thin distal urethra: a challenge in tubularized incised plate urethroplasty. Pediatr Surg Int 27, 755–760 (2011). https://doi.org/10.1007/s00383-011-2891-7

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  • DOI: https://doi.org/10.1007/s00383-011-2891-7

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