Tubularized Incised Plate in Previously Operated (redo) Hypospadias

Abstract

Hypospadiology, despite its decades of existence is still recognized as an evolving and expanding specialty. Three associated anomalies are classically found in hypospadias namely, an ectopic position of the urethral meatus anywhere from the ventral surface of penis to the perineum, a ventral curvature of the penis (chordee), and a defect of the ventral prepuce often referred to as dorsal hood. The only constant feature that defines hypospadias is the abnormal position of the meatus on the ventral surface of the penis.

Options for urethroplasty in children with hypospadias can be classified as tubularization of the urethral plate, skin flaps and grafts. Throughout the history of surgery for this condition flaps have been most commonly used, but in the past 10 years incision and tubularization of the urethral plate (tubularized incised-plate, TIP) has rapidly gained popularity for correcting distal, proximal and re-operative hypospadias. TIP potentially simplifies both decision-making and surgical technique, and has a low complication rate with better cosmetic results.We report our experience of using the tubularized incised plate (Snodgrass) for redo hypospadias repair in patients who have had one or more failed attempts at repair irrespective of the type of repair they had before.