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ORIGINAL ARTICLE
Year : 2018  |  Volume : 31  |  Issue : 1  |  Page : 212-217

Comparative study between tubularized incised plate urethroplasty with and without dorsal inlay graft


1 Department of Plastic Surgery, Faculty of Medicine, Menoufyia University, Shibin Al Kawm, Egypt
2 Department of Plastic Surgery, El-Obour Hospital, Kafr El-Sheikh, Egypt

Correspondence Address:
Mohammad R Mansour
Department Plastic Surgery, El-Obour Hospital, Kafr El-Sheikh
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_702_16

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Objectives The aim of this studywasto compare the results of two single-stage hypospadias repairs, namely, tubularized incised plate(TIP) repair with and without dorsal inlay preputial skin graft urethroplasty as regards meatal stenosis, urethral stricture, and cosmetic outcome. Background The most commonly performed operation to repair distal hypospadias is the TIP repair. The key step is midline incision of the urethral plate, which widens a narrow plate and converts a flat groove into a deep plate groove, ensuring a vertical, slitneomeatus and a normal-caliber neourethra. At times in cases of distal hypospadias, the urethral plate is very narrow and needs to be augmented or substituted for further tubularization. We report our experience with primary single-stage dorsal inlay urethroplasty using inner preputial skin grafts. Patients and methods This study included 30patients less than 10years old who presented with primary distal types of hypospadias with narrow urethral plate at the Department of Plastic Surgery, Menoufia University Hospital and were divided into two groups: groupA included 14patients operated by TIP without dorsal inlay graft and groupB included 16patients operated by TIP with dorsal inlay graft. Patients who had undergone circumcision, previous hypospadias repair, or who had a deeply grooved urethral plate were excluded. Results A total of 16 children underwent primary dorsal inlay preputial graft urethroplasty, of whom one(6.2%) child had partial wound dehiscence, two(12.5%) of the children had meatal stenosis, and one(6.2%) of these children developed urethral stricture; 14 children underwent TIP urethroplasty, of whom two(14.3%) children had wound dehiscence, four(28.6%) of the children had meatal stenosis, and four(28.6%) of these children developed urethral stricture. Conclusion Primary dorsal inlay inner preputial graft urethroplasty successfully fulfills all traditional hypospadias repair criteria. It offers a viable, safe, rapid, and easy option in the management of proximal hypospadias with a narrow urethral plate.


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