Multivariate analysis of factors associated with failure of tubularized incised plate urethroplasty repair for hypospadias: A prospective study

Saran Rama Kishan; Mirdha Kiran; Saran Sanya; Takhar Rajendra Prasad

Volume : VIII, Issue : IV, April - 2019

Multivariate analysis of factors associated with failure of tubularized incised plate urethroplasty repair for hypospadias: A prospective study

Saran Rama Kishan, Mirdha Kiran, Saran Sanya, Takhar Rajendra Prasad

Abstract :

Introduction: The tubularized incised plate urethroplasty (TIPU) is a standard technique widely used for the management of hypospadias. Aim: To evaluate the role of patients’ age and local penile factors affecting the outcomes of TIPUrepair for hypospadias. Materials and Methods: This was a prospective study conducted between April 2009 and October 2011. Patients with hypospadias who underwent TIPU were included in the study. The study variables were age, severity of hypospadias, degree of curvature and torsion, size of penisand glans, width of urethral plate, development of spongiosum and complication rate. The patients were followed up for 10 months to 2 years (mean: 20 months). Chi square test was used to compare between categorial variables. Results: A total of 125 patients with mean age 8.8 years (range: 6 months to 26 years) were studied. The complication rate between patients with >15 years and <5 years was 20% and 3.6% (p=0.08), respectively. Patients with proximal penile hypospadias had 30% of complications. The complication rate was significantly (p=0.001) associated with the degree of curvature, 35.7%, 30.8%, and 3.6% in severe, moderate and mild curvature, respectively. Complications were higher in patients with poorspongiosum and higher age (p=0.001) and in patients with narrow urethral plate (p=0.0001). Urethral fistula and stricture were the most commonly reported complications. The development ofurethral plate and spongiosum is directly proportional to the complication rate. Conclusion: Results showed that age of child, type of hypospadias, degree of curvature, quality of spongiosum and width of urethral plate are important factors associated with the TIPU outcomes Patients with >5 years of age, proximal hypospadias, poor spongiosum and narrow urethral plate have higher rate of complications.