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The aim of this study is to evaluate the outcomes, feasibility, and complication profile of re-operative hypospadias repair using tubularized incised plate urethroplasty as a single-stage procedure in a single-center experience.
Hypospadias repair remains one of the most common reconstructive procedures in pediatric urology; however, re-operative hypospadias represents a challenging subset due to distorted anatomy, urethral plate scarring, deficient local tissues, and higher complication rates compared with primary repairs.
The tubularized incised plate (TIP) urethroplasty, originally described by Snodgrass, revolutionized primary hypospadias repair and has since been adapted for selected reoperative cases. Contemporary evidence suggests that despite prior surgery and scary, a well-vascularized urethral plate of adequate width can still be successfully tubularized following a midline relaxing incision, offering acceptable functional and cosmetic outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study group | Children with recurrent or residual hypospadias in whom the urethral plate is deemed suitable for reuse. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tubularized Incised Plate Urethroplasty | Procedure | All procedures were performed under general anesthesia using the tubularized incised plate technique. After completing penile degloving and exposure of the urethral plate, a midline longitudinal incision was made along the entire length of the plate to allow tension-free tubularization. The urethral plate was then tubularized over an appropriate-sized urethral catheter using fine absorbable sutures. A well-vascularized dartos flap was harvested and interposed as a protective layer over the neourethra, followed by meticulous skin closure. |
| Measure | Description | Time Frame |
|---|---|---|
| Success rate | The success rate of tubularized incised plate urethroplasty reoperation after treatment was recorded. | 6 months after the procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of complications | Incidence of postoperative complications such as fistula, meatal stenosis, glans dehiscence, and urethral stricture were recorded. | 6 months after the procedure |
| Incidence of postoperative urethrocutaneous fistula |
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Inclusion Criteria:
Exclusion Criteria:
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We will conduct a retrospective review of 15 pediatric cases who presented or referred with complications requiring reoperation after primary hypospadias repair, including urethrocutaneous fistula, meatal stenosis, or poor urinary stream. This study will be conducted at Tanta university hospitals from January 2021 to december 2025. The data will be collected from 1st January 2026 to 1st February 2026.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University | Tanta | El-Gharbia | 31527 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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| ID | Term |
|---|---|
| D007021 | Hypospadias |
| ID | Term |
|---|---|
| D014564 | Urogenital Abnormalities |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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|
Incidence of postoperative urethrocutaneous fistula was recorded.
| 6 months after the procedure |
| Incidence of meatal stenosis | Incidence of meatal stenosis was recorded. | 6 months after the procedure |
| D010409 | Penile Diseases |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D052801 | Male Urogenital Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |