Repair of hypospadias complications using the tubularized, incised plate urethroplasty

Background/Purpose: Secondary procedures to correct complications after hyp ospadias repair remain challenging especially for "hypospadias cripples." T he tubularized, incised plate urethroplasty was first introduced by Snodgra ss for the repair of primary hypospadias in 1993. The authors used this pro cedure to correct the complications after hypospadias repair in patients wh o had no abundant local skin flaps to be used for a neourethra. Methods: Six patients underwent tubularized, incised plate urethroplasty fo r the correction of complications of hypospadias repair performed the previ ous year, including a large urethrocutaneous fistula (n = 1) and disruption of the neourethra (n = 5). Prior surgical procedures included transverse i sland tube urethroplasty in 4 cases and 2-stage urethroplasty in 2 cases. T he average patient age at the time of secondary procedure was 4.6 yea rs (r ange, 1 to 1 2 yea rs), Results: The mean follow-up period was 6 months (range, 2 months to 1 year) . All the patients obtained a functional neourethra with a vertical, slitli ke meatus. A small fistula developed in one child and mild meatal retractio n in another. Conclusions: The tubularized, incised plate urethroplasty offers few compli cations and good cosmetic results. The authors recommend its use for patien ts who have had repeated surgeries for hypospadias repair, especially those in whom only limited local skin flaps can be utilized for a neourethra. Co pyright (C) 1999 by W.B. Saunders Company.