Tubularized incised plate urethroplasty (Snodgross procedure) for distal penile hypospadias - a regional centre experience

Abstract

Tubularized incised plate (TIP) urethroplasty has rapidly become the procedure of choice for repair of distal penile hypospadias (DPH) at most of the centres throughout the world. Multiple series from major institutions have reported excellent cosmetic and functional results in conjunction with low complication rates. A retrospective review of 52 new cases of DPH where TIP urethroplasty was performed in Medical College Jammu has been analysed. Age range of the patients included in the study varied between 2 and 18 years with majority 47 (97.3%) below 5 years. Ten (19.9%) patients had chordee, which got corrected by degloving of the penis except 3 (5.7%) who required tunica albuginea plication. Neourethra was covered with vascularized pedicled dartos flap from the inner prepuce. Major complications occurred in 7 (13.4%) patients [urethrocutaneous fistula-5 (11.5%) patients, meatal stenosis-1 (1.9%) patient and complete breakdown-1 (1.9%) patient]. There were also minor complications like superficial skin necrosis in 10 (19.2%) patients and haematoma formation in 1 (1.9%) patient. Functional results as judged by the urinary stream, were good in 46 (88.8%) patients. Excellent cosmetic result was seen in 44 (84.6%) patients except 2 (3.8%) who had mild torsion of the shaft. Conclusion: Tubularized incised plate urethroplasty with dartos flap cover is a simple, single stage procedure for DPH with excellent cosmetic and functional results and is associated with minimal complications.

Keywords

• Dartos flap; Distal penile hypospadias; Snodgross procedure; Tubularized incised plate urethroplasty