Tubularized Incised Plate Urethroplasty (Tip) After Failed Hypospadias Repair

Background/Purpose: We report our experience with tubularized incised plate hypospadias reoperation in patients with failed previous hypospadias repair. Materials & Methods: Records of 30 patients with previous failed trials for hypospadias repair undergoing tubularized incised plate operation were reviewed. In 15 patients the neo urethras were covered with dartos flap or dartos tissue only, and in the other 15 patients the urethras were covered with dartos and tunica vaginalis flaps. Results: Complications occurred in 5 (17%) patients, consisting mostly of fistulas. Among 15 cases in whom dartos was used alone as a barrier layer fistulas occurred in 3(20%) cases, no fistulas occurred in any of the 15 patients in whom additional layer of tunica vaginalis flaps were added over dartos flaps. Meatal stenosis occurred in 2 cases one in each group. Conclusion: Tubularized incised plate urethroplasty in failed previously repaired hypospadias results in a functional neo urethra, the incidence of fistula is decreased when a barrier layer of dartos was used to cover the neo urethra and no fistulas occurred in patients in whom the neo urethra was covered with dartos and tunica vaginalis flaps.