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Nonstented Tubularized Incised Plate Distal Hypospadias Repair: A Single Center 5 Years’ Experience

  • Akram Assadi
    Affiliations
    Division of Pediatric Urology, Le Bonheur Children's Hospital, Memphis, TN

    Department of Urology, University of Tennessee Health Sciences Center, Memphis, TN
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  • Ahmad N. Alzubaidi
    Affiliations
    Division of Pediatric Urology, Le Bonheur Children's Hospital, Memphis, TN

    Department of Urology, University of Tennessee Health Sciences Center, Memphis, TN
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  • J. Kyle Cline
    Affiliations
    Division of Pediatric Urology, Le Bonheur Children's Hospital, Memphis, TN

    Department of Urology, University of Tennessee Health Sciences Center, Memphis, TN
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  • Cynthia Sharadin
    Affiliations
    Division of Pediatric Urology, Le Bonheur Children's Hospital, Memphis, TN

    Department of Urology, University of Tennessee Health Sciences Center, Memphis, TN
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  • A. Jill Travis
    Affiliations
    Division of Pediatric Urology, Le Bonheur Children's Hospital, Memphis, TN

    College of Nursing, University of Tennessee Health Sciences Center, Memphis, TN
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  • Kristen Marley
    Affiliations
    Division of Pediatric Urology, Le Bonheur Children's Hospital, Memphis, TN

    Department of Urology, University of Tennessee Health Sciences Center, Memphis, TN
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  • Christian Dewan
    Affiliations
    Division of Pediatric Urology, Le Bonheur Children's Hospital, Memphis, TN

    Department of Urology, University of Tennessee Health Sciences Center, Memphis, TN
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  • Joseph M. Gleason
    Correspondence
    Address correspondence to: Joseph M. Gleason, M.D., Le Bonheur Children's Hospital, Division of Pediatric Urology, 1920 Kirby Parkway, Suite 100, Germantown, TN 38138.
    Affiliations
    Division of Pediatric Urology, Le Bonheur Children's Hospital, Memphis, TN

    Department of Urology, University of Tennessee Health Sciences Center, Memphis, TN
    Search for articles by this author

      OBJECTIVES

      To report our immediate and delayed outcomes of nonstented tubularized incised plate (TIP) distal hypospadias repair.

      METHODS

      We retrospectively reviewed all charts of children who underwent distal hypospadias repair in a single children's hospital from 2013 to 2018. Patients’ demographics, hypospadias characteristics, operative technique, and immediate and delayed outcomes were recorded.

      RESULTS

      Of 280 consecutive distal hypospadias repairs that were identified, 74 were excluded due to the use of a repair other than TIP. Eleven stented TIP repairs were excluded as well. Of 195 nonstented repairs, immediate postoperative voiding complications were recorded in 11 (5.6%) and included multiple/split stream in 6 (3%), dysuria and voiding difficulty in 2 (1%), urinary retention in 2 (1%), and gross hematuria that spontaneously resolved in 1 (0.5%). Late follow up was recorded in 142 of 195 (72.8%) repairs. Delayed urethroplasty/glansplasty complications were recorded in 12 (8.5%) and included urethrocutaneous fistula in 10 (7.0%), meatal stenosis in 6 (4.2%) and glans/urethroplasty dehiscence in 2 (1.4%).

      CONCLUSION

      Avoiding postoperative urethral stents in distal hypospadias TIP repair reduces the morbidity associated with the stent and is a feasible option that carries acceptable immediate and delayed complication rates. Avoiding the stent eliminates stent-related bladder spasms, the need for other medications, and the short-term office visit for stent removal, therefore reducing parental anxiety, patient discomfort, and reducing cost.
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