Objective To present the experience of hypospadias repair using the tubularized incised plate urethroplasty (Snodgrass procedure). Methods FromMay 2001 to November 2004, 82 patients with hypospadias underwent the Snodgrassprocedure and the clinical data were analysed retrospectively. The mean age was5 years (1.5 to 16 years). These cases were divided into: the earlier stage group(34 cases) and the later stage group (48 cases); the proximal group (19 cases)and the distal and middle group (63 cases); the primary operational group (49 cases) and the reoperational group (33 cases). Results Fistulas ocurred in 12 patients (14.6%), complete glans dehiscednce in 1 case. Fistula were as follows: 11 cases in the earlier stage group (32.4%) and 1 case in the later stage group（2.1%）;2 cases in the proximal group (10.5%) and 10 cases in the group of distal and middle group (15.9%); 8 cases in the primary operational group (16.1%) and 4 cases in the reoperational group (12.1%). There was statistically significant difference in the incidence of fistula between the earlier stage group and the later stage group (Plt;0.01). There was no statistically significant difference between the proximal group and the distal and middle group, between the primary operational group and the reoperational group (Pgt;0.05). All patients were followed up more than one month. The neo meatus was innormal position. The results of penile cosmetic and urethral function were satisfactory. Of these cases, 15 were followed up 1.5-6.0 months. The average flow rate was 7.8 ml/s(6.8-10.5 ml/s). The mean of maximum flow rate was 10.5 ml/s (8.8-14.5 ml/s).Conclusion Excellent neourethrol functional and superior casmetic resalts with low rate of complication can be gained by using tubularized incised plate urethroplasty for the cases of hypospadias without chordee or with mild chordee. But the preputialflap procedure should be chosen in condition that the hypospadias was association with obvious chordee.
ObjectiveTo comparatively analyze the effect of one-stage nonstented tubularized incised plate urethroplasty (TIP) on operative pain and compl ication by comparing with urethral catheter and urethral stent drainages. MethodsBetween March 2010 and June 2013, 214 cases of distal and mid-shaft hypospadias underwent TIP, and the cl inical data were analyzed retrospectively. The patients were divided into 3 groups based on different urinary drainage techniques: indwell ing urethral catheter was used in 68 cases (group A), indwell ing urethral stent in 70 cases (group B), and nonstented drainage in 76 cases (group C). There was no significant difference in age, hypospadias type, and accompany malformation among 3 groups (P>0.05). At 2 days after operation, Wong-Banker facial scale (WBS) and Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) were used for pain and praxiology assessment. The complications after operation also were observed and compared among 3 groups. ResultsAll patients were followed up 6-25 months (median, 11.8 months). At 2 days after operation, the median WBS scores were 4.0 (0-10), 3.5 (0-10), and 3.0 (0-10) in groups A, B, and C, respectively; median CHEOPS pain scores were 6.0 (1-13), 6.0 (1-13), and 4.0 (1-11), respectively. The WBS pain score and CHEOPS pain score in group C were significantly lower than those in groups A and B (P<0.05), but there was no significant difference between group A and group B (P>0.05). The postoperative complication occurred in 27 cases (39.7%) of group A, 29 cases (41.4%) of group B, and 13 cases (17.1%) of group C; two or more than two complications occurred in 14, 15, and 9 cases, respectively. There was significant difference in total incidence of postoperative complication among 3 groups (P<0.05). The incidences of postoperative overactive bladder, bladder spasms, urinary tract infection, and fistula in group C were significantly lower than those in groups A and B (P<0.05). There was no significant difference in incision infection, acute urinary retention, urinary extravasation, meatal stenosis, and urethral stricture among 3 groups (P>0.05). ConclusionOne-stage nonstented TIP is suitable for distal and mid-shaft hypospadias and could reduce postoperative pain and complications compared with the traditional postoperative indwell ing urethral catheter and indwell ing urethral stent.