Objective: Tubularized incised plate (TIP) urethroplasty is performed by many pediatric urologists and has been widely accepted for repair of distal and mid-shaft hypospadias. However, the role of urethral catheter placement in TIP repair remains controversial. In this study, the surgical outcomes of indwelling urethral catheter and non-catheter TIP repairs in boys with hypospadias were compared. Methods: A total of 254 patients with primary distal and mid-shaft hypospadias underwent TIP repair and were evaluated retrospectively. A urethral catheter was placed in 103 patients (group A) and non-catheter repair was performed in 151 patients (group B). Information obtained included age, toilet training, chordee, type of hypospadias, presence or absence of a catheter, and postoperative complications. The complications recorded included wound infection, urinary tract infection, bladder spasm, urinary retention, urinary extravasation, meatal stenosis, urethral stricture, and urethrocutaneous fistula. Results: There was no statistical difference in age, toilet training, chordee, hypospadias site, or performing surgeon between the two groups. The median follow-up time was 22 and 24 months for groups A and B, respectively. The rate of bladder spasms (10.7 vs. 0%, p < 0.001) and urinary tract infection (9.7 vs. 3.3%, p = 0.034) was significantly higher for group A than group B. Although the rate of urinary retention was higher in group B than in group A (4.0 vs. 0%), there was no statistically significant difference between the two groups (p = 0.084). Likewise, the incidence of urethrocutaneous fistula and meatal stenosis was not significantly different. Conclusion: Non-catheter TIP repair is feasible and positive outcomes can be achieved with minimal complications and less patient discomfort.

Keywords:
Hypospadias, Catheter, Tubularized incised plate repair
1.
Lu J, Jin YM, Nie HB, Xiao YS, Shen W, Dan MJ, Tong L, Hu WL: Superiority of modified method in urine drainage for hypospadias repair: a 20 years' experience with 864 cases. Zhonghua Yi Xue Za Zhi 2011;91:3278-3280.
2.
Aigrain Y, Cheikhelard A, Lottmann H, Lortat-Jacob S: Hypospadias: surgery and complications. Horm Res Paediatr 2010;74:218-222.
3.
Roberts J: Hypospadias surgery past, present and future. Curr Opin Urol 2010;20:483-489.
4.
Snodgrass WT, Bush N, Cost N: Tubularized incised plate hypospadias repair for distal hypospadias. J Pediatr Urol 2010;6:408-413.
5.
Springer A, Krois W, Horcher E: Trends in hypospadias surgery: results of a worldwide survey. Eur Urol 2011;60:1184-1189.
6.
Turial S, Enders J, Engel V, Schier F: Stent-free tubularized incised plate (TIP) repair of distal and mid-shaft hypospadias irrespective of age. Eur J Pediatr Surg 2011;21:168-170.
7.
Leclair MD, Camby C, Battisti S, Renaud G, Plattner V, Heloury Y: Unstented tubularized incised plate urethroplasty combined with foreskin reconstruction for distal hypospadias. Eur Urol 2004;46:526-530.
8.
Sarhan OM, El-Hefnawy AS, Hafez AT, Elsherbiny MT, Dawaba ME, Ghali AM: Factors affecting outcome of tubularized incised plate (TIP) urethroplasty: single-center experience with 500 cases. J Pediatr Urol 2009;5:378-382.
9.
Almodhen F, Alzahrani A, Jednak R, Capolicchio JP, El Sherbiny MT: Nonstented tubularized incised plate urethroplasty with Y-to-I spongioplasty in non-toilet trained children. Can Urol Assoc J 2008;2:110-114.
10.
Buson H, Smiley D, Reinberg Y, Gonzalez R: Distal hypospadias repair without stents: is it better? J Urol 1994;151:1059-1060.
11.
El-Sherbiny MT: Tubularized incised plate repair of distal hypospadias in toilet-trained children: should a stent be left? BJU Int 2003;92:1003-1005.
12.
Fathi K, Pinter A: Dribbling diversion in Y-V glanuloplasty modified Mathieu repair. Eur J Pediatr Surg 2009;19:87-89.
13.
Arda IS, Mahmutoglu M: Urethral catheterization in hypospadias surgery: Should the device enter the bladder or be made a urethral stent? J Pediatr Surg 2001;36:1829-1831.
14.
Minevich E, Pecha BR, Wacksman J, Sheldon CA: Mathieu hypospadias repair: experience in 202 patients. J Urol 1999;162:2141-2142; discussion 2142-2143.
15.
Hafez AT, Herz D, Bagli D, Smith CR, McLorie G, Khoury AE: Healing of unstented tubularized incised plate urethroplasty: an experimental study in a rabbit model. BJU Int 2003;91:84-88.
© 2013 S. Karger AG, Basel
2013
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