ESPU Congress 2017 - Abstract book

CONGRESS OF THE ESPU

S8-10 (P without presentation)

GRAFTED TUBULARIZED INCISED

URETHROPLASTY,VISION TO THE FUTURE;EVALUATION

AFTER 5 YEARS IF SINGLE SURGEON EXPERIENCE

Mamdouh AHMED

, Islam AMER

, Ashhad KHAN

and Paradip VINCENT

1) Ibn Sina Hospital, Paediatric Urology, Kuwait, KUWAIT - 2) Ibn sina hospital kuwait, Pediatric Urology Unit, Kuwait,

KUWAIT - 3) Ibn sina hospital, Pediatric Urology Unit, Kuwait, KUWAIT

PURPOSE

Grafted TIP was described for redo cases and we extended its indication to be our standard tech-

nique for primary hypospadias repair.

Grafting of the incised urethral plate gives the ability of positiong of neomeatus in its anatomical

position with decrease the chance of meatal stenosis and reducing the incidence of complication as

urethro-cutaneous fistua and neourethral tract stricture.

We evaluate 5 years’ experience of G-TIP technique of single surgeon experience with reported

complications and how to avoid them.

MATERIAL AND METHODS

A total of 400 consecutive primary hypospadias patients undergoing the G-TIP procedure were

prospectively studied between 2012 and 2016 operated by single surgeon where the incised ure-

thral plate was grafted using inner prepetial graft. Patients where observed for neomeatus site and

shape , urethro-cutaneous fistula , residual chordee , glanular dehiscence , urine stream caliber

and meatal stenosis.

RESULTS

Among the total number of patients 111 were coronal, 185 subcornal, 60 Distal penile, 35 mid

penile, 9 Proximal

Slit like apical neomeatus was present in 397 of patients, fistula occurred in 11 Of patients, 2 patients

who developed very thin stream of urine which required cystoscopy and internal urethrotomy due to

extension of incision distally into normal urethra when fixing the prepetial graft.

3 patients who developed partial glanular dehiscence resulting in distal glanular meatus none of

them required surgical correction with accepted neomeatus.

None of our patients developed meatal stenosis.

Over all 96% of our patients achieved excellent functional and cosmetic results.

CONCLUSIONS

We conlude that after 5 years of performing G-TIP technique in all cases of primary hypospadias

achieving excellent normal anatomical neomeatus , with less incidence of urethro-cutaneous fistula

and meatal stenosis.

We believe that worldwide acceptance of this TIP modification technique will be increased by time.