Functional evaluation of tubularized-incised plate repair of midshaft-proximal hypospadias using uroflowmetry

Objective To determine objectively, using uroflowmetry, the functional resu lts of the tubularized-incised plate urethroplasty to repair midshaft-proxi mal hypospadias. Patients and methods Twenty-one patients (mean age 4 years , mean follow-up 1.8 years) were selected from those undergoing surgery bet ween January 1996 and January 1998 at our institution. All patients had mid shaft-proximal hypospadias and were treated using the Snodgrass technique. Patients were included if they were able to void volitionally and had no fi stula. The flow pattern, maximum (Q(max)) and mean flow rate (Q(ave)) were measured: the results were expressed as percentiles and compared with publi shed values from normal children. The Q(max) and Q(ave) were considered nor mal if >25th percentile, as equivocally obstructed when in the 5-25th perce ntile and obstructed if < 5th percentile. Results Fourteen patients were considered normal. four as equivocally obstr ucted and three as obstructed. Of the second group, one patient had a ureth ral diverticulum at the native meatus (confirmed by voiding cysto-urethrogr aphy) and the remaining three patients had mealal stenosis that responded t o dilatation, with normal flow in two and improvement in the other. Of the obstructed group, one patient responded to dilatation and two underwent mea toplasty. Conclusion The tubularized-incised plate repair provides satisfactory funct ional results thr midshaft-proximal hypospadias: uroflowmetry is an importa nt noninvasive tool to evaluate this technique. A long-term follow-up is ne eded to confirm these results.