Omar Rabea Gomaa, Khalil Mostafa M, Shereef Hammouda W, Al Ashram Mahmoud R, Elshaer Alaa
Department of Urology, Benha University, Benha, Egypt.
Department of Urology, Benha Teaching Hospital, Benha, Egypt.
Urol Ann. 2023 Jul-Sep;15(3):271-277. doi: 10.4103/ua.ua_14_23. Epub 2023 Jun 16.
Tubularized incised plate (TIP) is the most common technique used for distal hypospadias repair with good outcome but with a high rate of urethral stricture. Inner preputial-free graft can be used as an inlay graft in the incised area of the narrow urethral plate, also can be used as an onlay graft for urethroplasty in hypospadias repair to avoid this complication.
A comparative prospective randomized study was conducted on two groups of hypospadias patients with narrow urethral plate. Group A: dorsal inlay inner preputial graft repair was performed (grafted TIP [G-TIP]) and Group B: ventral onlay preputial graft repair was performed. The assessment of outcome and hypospadias objective scoring evaluation (HOSE) score was done at 2 weeks and 6 months.
Group A included 55 patients for whom dorsal inlay inner preputial graft repair was performed (G-TIP), and Group B which was planned to be conducted on 55 patients using onlay preputial graft (onlay graft) but was terminated after 15 cases due to high failure rate (33%). Group A showed better success rate 96% and better HOSE score (score 16) at 2 months and 6 months 83.6% and 88.2% versus 26.7% and 33.3% in Group B. Postoperative complications showed a statistically significant difference; glans dehiscence (3.6% vs. 40%), wound infection (1.8% vs. 33.3%), and skin sloughing (3.6% vs. 26.7%) in Groups A and B, respectively.
G-TIP is a good technique for the management of distal hypospadias with narrow urethral plate with good success rate, cosmetic outcome, and with less complications compared to onlay graft.
管状切开包皮板（TIP）是治疗远端尿道下裂最常用的技术，效果良好，但尿道狭窄发生率较高。包皮内无蒂移植物可作为嵌合移植物用于狭窄尿道板的切开区域，也可作为覆盖移植物用于尿道下裂修复中的尿道成形术，以避免这种并发症。
对两组尿道板狭窄的尿道下裂患者进行了一项比较性前瞻性随机研究。A组：行背侧嵌合包皮内移植物修复术（移植TIP [G-TIP]），B组：行腹侧覆盖包皮移植物修复术。在术后2周和6个月对结果进行评估，并进行尿道下裂客观评分评估（HOSE）评分。
A组有55例患者接受了背侧嵌合包皮内移植物修复术（G-TIP），B组计划对55例患者使用覆盖包皮移植物（覆盖移植物），但由于失败率高（33%），在15例患者后终止。A组在2个月和6个月时显示出更好的成功率（96%）和更好的HOSE评分（评分16），分别为83.6%和88.2%，而B组为26.7%和33.3%。术后并发症显示有统计学显著差异；A组和B组的龟头裂开率分别为（3.6%对40%）、伤口感染率（1.8%对33.3%）和皮肤脱落率（3.6%对26.7%）。
G-TIP是治疗尿道板狭窄的远端尿道下裂的一种良好技术，成功率高，美容效果好，与覆盖移植物相比并发症更少。
