ESPU Congress 2018 - Abstract Book

CONGRESS OF THE ESPU

CONCLUSIONS

Staged repair using buccal or inner preputial grafts in crippled hypospadias carries a good success

rate. The most common complication is glanular dehiscence especially in proximal cases.

11:24–11:27

S7-8 (PP)

PROXIMAL HYPOSPADIAS REPAIR: A COMPARISON

BETWEEN BILATERAL EXTERNAL SKIN TUBE (BEST)

AND TUBULARISED INCISED PLATE (TIP) TECHNIQUES

Phitsanu MAHAWONG

, Jaraspong VUTHIWONG

, Wilaiwan CHONGRUKSUT

and

Bannakij LOJANAPIWAT

1) Chiang Mai University, Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai, THAILAND -

2) Chiang Mai University, Research Unit, Department of Surgery, Faculty of Medicine, Chiang Mai, THAILAND

PURPOSE

The study objective is to compare bilateral external skin tube (BEST) and tubularised incised plate

(TIP) repairs for treatment of proximal hypospadias.

MATERIAL AND METHODS

Between January 2009 and September 2017 92 boys underwent proximal hypospadias (perineum

to proximal penile shaft meatus) repair. BEST repairs were performed in 54 patients and TIP repairs

were performed in 38 patients. The principle of BEST repair is to use parameatal-based flaps with

external foreskin extension for tubularised neourethroplasty. All the operations were done by one

surgeon. Patient data was retrospectively reviewed.

RESULTS

The mean ages were 4.2 and 4.4 years old for BEST and TIP repairs, respectively (p=0.820).

The mean operative times were 141.3 and 146.2 minutes in BEST and TIP repairs, respectively

(p=0.450). The mean catheter time was 8.8 days in the BEST group and in the TIP group was

9.9 days (p=0.004). The mean postoperative hospital stay was 9.3 days in the BEST group and

10.1 days in the TIP group (p=0.062). The mean follow-up times were 12.1 months and 26.2 months

for the two groups respectively (p<0.001). Fistulas occurred in 13/54 (24.0 %) and 8/38 (21.1 %)

of cases in the BEST and TIP repair groups, respectively (p=0.805). Wound bleeding, glans de-

hiscence, recurrence of ventral curvature, and meatal stenosis rates were not statistically different

between the two groups.

CONCLUSIONS

BEST and TIP repairs are equally effective for treating proximal hypospadias. However a BEST

repair requires a shorter catheter time than TIP repair.