Hypospadias Repair: An Overview of the Actual Techniques

Subramaniam, Ramnath; Spinoit, Anne‐Françoise; Hoebeke, Piet

doi:10.1055/s-0031-1281490

Cited by 69 publications

(70 citation statements)

References 75 publications

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“…The choice of the technique was at the treating physician's discretion, but techniques were systematically performed by our 'in house' standards [6]. When applying the incised plate technique, a slightly modified tubularized incised plate (TIP) urethroplasty was applied, with a running single layered suture material, covered by two barrier layers [6].…”

Section: Standard Techniques and Follow-upmentioning

confidence: 99%

“…No technique has ever emerged as a gold standard as no high-level evidence has ever shown the superiority of one technique over another [6,7]. There seems, however, to be an increasing trend in recent decades to perform incised plate urethroplasty for distal hypospadias and two stage urethroplasty for proximal hypospadias [8], and the European Association of Urology (EAU) guidelines even propose an algorithm for choosing a technique [5], but this is only based on low-level evidence.…”

Section: Introductionmentioning

confidence: 99%

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Grade of hypospadias is the only factor predicting for re-intervention after primary hypospadias repair: A multivariate analysis from a cohort of 474 patients

Spinoit

Poelaert

Praet

et al. 2015

Journal of Pediatric Urology

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Section: Standard Techniques and Follow-upmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Grade of hypospadias is the only factor predicting for re-intervention after primary hypospadias repair: A multivariate analysis from a cohort of 474 patients

Spinoit

Poelaert

Praet

et al. 2015

Journal of Pediatric Urology

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“…Gozar and coworkers (16) reported that success rate in the re--operation of proximal hypospadias cases is 60% while in distal cases it is about 89%. Subramaniam et al (22) reviewed the techniques for distal hypospadias repair and concluded that most surgeons prefer this technique. However, this method, which results in complication in about 33% of cases, has not been yet accepted for the proximal hypospadias.…”

Section: Flap Types and Tip Reoperationmentioning

confidence: 99%

Tubularized incised plate urethroplasty for hypospadias reoperation: a review and meta-analysis

Mousavi

Aarabi

2014

Int. braz j urol.

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ARTICLE INfO ______________________________________________________________ ______________________Purpose: Tubularized Incised Plate (TIP) urethroplasty is a technique for urethral reconstruction of hypospadias although there are some controversies for its use in recurrent cases. The aim of this study was to review the results of TIP technique in various studies and the usage of different flaps for covering the repair site. Material and Methods: Extensive Search was performed for articles published between 1994 and 2013 in common electronic databases. The overall TIP complication rates were estimated by a fixed effects model meta-analysis.Results: 17 articles of hypospadia repair using the TIP method were reviewed. All studies performed surgery and repair on the basis of the Snodgrass's method; however, some introduced modifications to the method. The prevalence of complications in repeated TIP surgery was 11.1 to 33.3% and the most prevalent complication in different studies was fistula. Based on the meta-analysis, the overall estimation of complications was 21.8 % (95% CI: 18.3 to 25.5). Conclusion:Most studies performed the incision of the urethral plate to create a supportive coverage upon neourethra, and confirmed its success. We recommend further investigation on using different flaps in well-designed randomized controlled trials to choose the best surgical method for repairing recurrent hypospadias.

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“…1 A large proportion of these cases are distally located. 2 Despite this, there is no consensus on the optimal surgical technique for distal hypospadias. 3,4 There are over 300 surgical techniques described for repairing hypospadias.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 There are over 300 surgical techniques described for repairing hypospadias. 2,5 However, the Snodgrass tubularized incised plate urethroplasty (TIP) is perhaps the most commonly performed contemporary repair. 6 A study done by Springer and colleagues surveyed surgeons who operate on hyposadias and found that in distal hypospadias (subcoronal to midshaft), the TIP repair was preferred by 52.9% to 71.0% of participants.…”

Section: Introductionmentioning

confidence: 99%

A modification of the TIP procedure for distal hypospadias: The burrowing technique

Wishart

Metcalfe

2014

CUAJ

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Introduction: The tubularized incised plate urethroplasty (TIP) hypospadias repair is a commonly performed procedure for hypospadias. Multiple series document excellent cosmetic outcome in conjunction with low complication rates. We describe a modification that we have named the "burrowing technique." We believe that this technique facilitates dissection of the glans, which improves mobility, decreases tension with closure, and potentially improves outcomes. Methods: A retrospective review was performed of 193 coronal or mid-shaft hypospadias repairs by a single surgeon. The first 98 were performed using the TIP procedure, then the burrowing technique was developed and a subsequent 95 were analyzed for outcomes using this modification. Urethral plate characteristics and glandular size did not influence the choice of surgical technique. Cases were selected to allow for a "learning curve," and were consecutively accrued. None of the boys had undergone prior hypospadias surgery. Proximal 2 stage repairs and distal (glanular) repairs were excluded. Results: A total of 193 boys underwent repair, 98 with the traditional TIP procedure and 95 using the burrowing modification. In total, 37 (19.2%) patients required re-operation for either fistulas or dehiscence; 23 (23.5%) in the non-burrowing group and 14 (14.7%) in the burrowing group, odds ratio 0.54 (p = 0.10). Conclusions:The TIP procedure has revolutionized the management of distal hypospadias. The burrowing modification increases glandular mobility simplifying the procedure and demonstrates a non-statistically significant trend in reducing reoperation rates.

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Hypospadias Repair: An Overview of the Actual Techniques

Cited by 69 publications

References 75 publications

Grade of hypospadias is the only factor predicting for re-intervention after primary hypospadias repair: A multivariate analysis from a cohort of 474 patients

Grade of hypospadias is the only factor predicting for re-intervention after primary hypospadias repair: A multivariate analysis from a cohort of 474 patients

Tubularized incised plate urethroplasty for hypospadias reoperation: a review and meta-analysis

A modification of the TIP procedure for distal hypospadias: The burrowing technique

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