Introduction and Objectives
Tubularized incised plate urethroplasty has become a popular technique for repairing distal and proximal hypospadias in many institutions. Dorsal inlay graft urethroplasty has been described as an effective method for hypospadias repair and leads to good cosmetic outcome with low risk of complications. The main advantages of this procedure are; early removal of the urethral catheter and reducing the risk of meatal stenosis. We aimed to prospectively evaluate urine flow rates at early and late-term follow-ups in the dorsal inlay graft urethroplasty technique in primary hipospadias repair.
Material and Methods
Consecutive 45 patients with primary hypospadias undergoing TIPU by using inlay dorsal graft between June 2006 and June 2008 were enrolled into this study. Posterior urethral plate is incised and the graft prepared from prepuce is sutured from the old meatus to the tip of the glans. Urethra is sutured with 6/0 vicryl over the 8f urethral catheter. The urethral catheters were removed at 24–48 postoperatively in all subjects. Urine flow measurements were performed at early and late follow-up periods. The uroflowmetric parameters were compared between a mean of 10 days and 8.7 months postoperatively using the t test and p < 0.05 was accepted as statistically significant. All patients were also evaluated for the cosmetic results and complications rates.
Results
The mean age of all cases was 7.36±3.95 (2–17) years. Two patients had proximally and 43 had distally located hypospadias. In all patients, neo-meatus with a slitlike appearance was observed postoperatively at the tip of the glans penis. Postoperative fistula was encountered in 6 patients (13.33 %). No stenosis has been detected in all subjects. In patients who achieved voiding habit and who did not have chordee or fistula, an uroflowmetric study was carried out at 10 days and a mean of 8.7 months postoperatively. A urine flow measurement at 10 days (Mean Qmax: 7.85±3.52 ml/sec and Qave: 4.86±2.15 ml/sec) and 8.7 months (Mean Qmax: 9.34±5.4 ml/sec and Qave: 6.85±4.17 ml/sec) revealed statistically comparable results (p = 0.357 and p = 0.203, respectively).
Conclusions
Dorsal inlay graft urethroplasty allows the early removal of the urethral catheter after hypospadias repair. In this study, we demonstrated that uroflowmetric parameters in a successful TIPU procedure with inlay dorsal graft were not different and the complication rates are satisfying at the early and late follow-up periods.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
