Department of Pediatric Surgery, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.
Department of Pediatric Surgery, Shandong Provincial Hospital Afiliated to Shandong First Medical University, Jinan, China.
BMC Surg. 2024 Apr 12;24(1):104. doi: 10.1186/s12893-024-02400-8.
To compare the outcomes of hypospadias repair using tubularized incised plate (TIP) urethroplasty and modified TIP with lateral skin to widen the urethral plate (WTIP).
Data were obtained from pre-pubertal boys who underwent primary hypospadias repair between May 2018 and July 2023. The cases were divided into two groups; one group underwent TIP with urethral plate ≥ 6 mm width and the other group with urethral plate width < 6 mm underwent WTIP. WTIP urethroplasty was performed by widening incisions on the outer margins of the urethral plate to incorporate penile and glandular skin lateral to the urethral plate to facilitate tubularization. Complication rates and urinary functions were compared.
A total of 157 patients were enrolled in this study. Eighty-eight cases with narrow urethral plate were subjected to WTIP urethroplasty, and the rest were subjected to TIP urethroplasty. The preoperative glans width in WTIP group was less than that in TIP group (P < 0.001), and 44.3% had midshaft meatus in WTIP group compared to 17.4% in TIP group (P < 0.001). However, the incidences of postoperative complications (17.6% vs. 21.6%, P = 0.550) were not statistically different between the TIP and WTIP groups. In addition, both groups did not differ significantly in postoperative uroflowmetry assessment.
The described technique helps to create an adequately caliber aesthetic neomeatus and facilitates tubularization, especially in hypospadias with a narrow urethral plate. Our data suggest that augmentation of a narrow urethral plate with WTIP has a similar surgical outcome to that of the TIP procedure in patients with a wide urethral plate.
比较使用管状切开皮瓣（TIP）尿道成形术和改良 TIP 联合侧方皮肤加宽尿道板（WTIP）治疗尿道下裂的疗效。
资料来源于 2018 年 5 月至 2023 年 7 月期间行初次尿道下裂修复术的青春期前男孩。病例分为两组，一组采用尿道板宽度≥6mm 的 TIP，另一组尿道板宽度<6mm 行 WTIP。WTIP 尿道成形术通过加宽尿道板外边缘切口，将阴茎和腺体皮肤纳入尿道板外侧，便于管状化。比较并发症发生率和尿功能。
共纳入 157 例患者。88 例尿道板狭窄患者行 WTIP 尿道成形术，其余患者行 TIP 尿道成形术。WTIP 组术前龟头宽度小于 TIP 组（P<0.001），WTIP 组有 44.3%为中段尿道外口，而 TIP 组为 17.4%（P<0.001）。然而，TIP 组和 WTIP 组术后并发症发生率（17.6%比 21.6%，P=0.550）无统计学差异。此外，两组术后尿流率评估也无明显差异。
该技术有助于形成足够口径的美学新尿道口，并便于管状化，尤其是在尿道板狭窄的尿道下裂患者中。我们的数据表明，在尿道板较窄的患者中，WTIP 加宽尿道板与 TIP 手术具有相似的手术效果。
