Comparison of meatal-based flap (Mathieu) and tubularized incised-plate (TIP) urethroplasties for primary distal hypospadias: A systematic review and meta-analysis

Zhang, Yuanfeng; Shen, Zeren; Zhou, Xinye; Chi, Zepai; Hong, Xuwei; Huang, Yi; Huang, Hong; Chen, Shaochuan; Lan, Kaijian; Lin, Jia‐Hua; Wu, Weichu; Zhou, Yizhou

doi:10.1016/j.jpedsurg.2020.03.013

Cited by 7 publications

(8 citation statements)

References 24 publications

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“…As regard to the achieved meatal shape after surgery, the majority of patients in our study (90% of cases in Snodgraft group and up to 96.7% of cases in the Snodgrass group) eventually had an acceptable normal-looking penis with a slit shaped opening of meatus. This matched the general consensus that successful hypospadias urethroplasty is defined to have a slit-like meatus at its tip, a functional urethra with normal stream (Zhang et al, 2020).…”

Section: Resultssupporting

confidence: 67%

Snodgraft Versus Snodgrass Repair of Primary Distal Hypospadias: A Comparative Study

Zaki¹,

Shafei²,

Mohamed³

2021

Int.J.Curr.Microbiol.App.Sci

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Section: Resultssupporting

confidence: 67%

Snodgraft Versus Snodgrass Repair of Primary Distal Hypospadias: A Comparative Study

Zaki¹,

Shafei²,

Mohamed³

2021

Int.J.Curr.Microbiol.App.Sci

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“…Twenty-five (58%) patients had distal hypospadias and 18 (42%) patients had mid shaft hypospadias. Mid shaft hypo-tula in TIP urethroplasty is more related to the width of the plates than other factors and some surgeons still prefer other methods such as combining with a Mathieu procedure or other modifications for narrow urethral plate [7][8][9]. This article addressed the issue of urethral plate in TIP urethroplasty for distal and mid shaft hypospadias from the perspective of a tertiary paediatric surgical center from a developing country.…”

Section: Resultsmentioning

confidence: 99%

“…A recent meta-analysis that compared TIP and Mathieu procedure suggested that they were equivalent in terms of fistula, wound dehiscence, and flap necrosis but there was a significantly lower rate of meatal stenosis with Mathieu rather than with TIP. They commented that the modified Mathieu technique and a running suture for urethroplasty could be related to a lower rate of meatal stenosis [8].…”

Section: Nonementioning

confidence: 99%

Tabularised Incised Plate (TIP) Urethroplasty in Narrow V/S Wide Urethral Plate: A Comparative Study in a Developing Country Perspective

Walid¹,

Minhajuddin²,

Rajib³

et al. 2021

Arch of Pedia Surg

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Introduction: Tubularized incised plate (TIP) urethroplasty is the most commonly performed operation for distal and mid shaft hypospadias. There are controversies in the previous reports regarding the association between urethral plate width and complications in TIP repair. The aim of this study was to compare the impact of urethral plate width in TIP repair on the development of complications in the perspective of a developing country.Methods: It was a prospective comparative study carried out in the department of pediatric surgery, Chittagong Medical College Hospital, Bangladesh from December, 2017 to March, 2019. Patients with distal and midshaft hypospadias were divided into 2 groups: Group A-urethral plate less than 8 mm wide and Group B-urethral plate 8 mm or more wide. Age at surgery, penile characteristics, pre-incision urethral plate width, per-operative factors and development of complications were analyzed. Follow up period ranged from 6 months to 2.5 years.Results: A total of 43 patients (21 in group A, 22 in group B), with a mean age of 6.67 ± 3.38 years underwent TIP repair. Twenty-five (58%) patients had distal penile and 18 (42%) had mid shaft hypospadias. Age correlated with glans size and urethral plate width (P = 0.019 and 0.003, respectively) but there was no significant difference in age between patients with or without development of complications (P = 0.71). Complications developed in 18 (41.87%) patients, 9 in each group. Mean urethral plate width was 7.37 ± 0.84 mm and 7.19 ± 1.17 mm in patients who had successful repair and those developed complications, respectively (P = 0.59). Duration of tourniquet, size of catheter, layers of repair, duration of dressing or catheter were not also associated with UC fistula, the most common complication (P = 0.26, 0.58,0.76, 0.38, and 0.56, respectively). Conclusion:Width of urethral plated was not related to development of complications in TIP repair. Complication rates were high in comparison to other studies and skill development and improvement of other factors are necessary in the developing world to improve outcome.

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“…While most cases are distal hypospadias, they are rarely complicated by severe penile curvature (SPC) [2], because glandular hypospadias (GH) with SPC is an unusual deformity in children. Distal hypospadiases are usually repaired with a tubularized incised plate or the Mathieu or meatal advancement and glanuplasty inclusive techniques, but these are not suitable for GH with SPC [3,4]. A few techniques have been proposed for this condition; however, none have been satisfactory [5].…”

Section: Introductionmentioning

confidence: 99%

Single-stage versus staged interposition urethroplasty for glandular hypospadias with severe penile curvature: 15-year experience

Zhou

Yin

et al. 2021

World J Urol

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Purpose Our study examined the benefit of an alternative interposition urethroplasty (IU) procedure for glandular hypospadias (GH) with severe penile curvature (SPC). The technique involved transecting and reconstructing the urethra to preserve the distal glandular and coronal urethra and correct the curvature. We compared procedural characteristics, outcomes, and surgical complications for the single-stage and staged IU techniques. Methods We retrospectively studied 44 patients with GH with SPC who underwent single-stage or staged IU between March 2005 and June 2020. Demographics, operative details, complications, and uroflometry findings were analyzed. Results The median age at initial surgery was 37.5 months. Ten patients underwent single-stage IU repair, and 34 patients underwent staged IU repair. The median length of the interposition neourethra was 3.2 cm (2.2–4.3). The median follow-up duration was 58 months, and the overall complication rate was 13.6%. Complications were noted in 30% (3/10) and 8.8% (3/34) of patients in the single-stage and staged IU groups, respectively (p > 0.05). Fistula formation was noted in one and three patients in the single-stage and staged groups, respectively (8.8% vs. 10%, p > 0.05). Two cases of urethral stricture were documented in the single-stage group only. No chordee recurrence or urethral diverticula was noted in any of the patients. Conclusion IU is a reliable and durable technique for GH with SPC. It avoided penile shortening, preserved the distal urethra, and reduced the risk of chordee recurrence. The staged IU technique had more superior outcomes compared to the single-stage IU technique.

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Comparison of meatal-based flap (Mathieu) and tubularized incised-plate (TIP) urethroplasties for primary distal hypospadias: A systematic review and meta-analysis

Cited by 7 publications

References 24 publications

Snodgraft Versus Snodgrass Repair of Primary Distal Hypospadias: A Comparative Study

Snodgraft Versus Snodgrass Repair of Primary Distal Hypospadias: A Comparative Study

Tabularised Incised Plate (TIP) Urethroplasty in Narrow V/S Wide Urethral Plate: A Comparative Study in a Developing Country Perspective

Single-stage versus staged interposition urethroplasty for glandular hypospadias with severe penile curvature: 15-year experience

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