Risk Factors for Re-operation Following Tubularized Incised Plate Urethroplasty: A Comprehensive Analysis

Objectives To review our 10-year experience with tubularized incised-plate (TIP) urethroplasty and determine the risk factors for reoperation. Methods The hospital records of 391 patients underwent the TIP procedure from April 1997 to September 2007 were reviewed retrospectively. Data were collected...

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 2011-03, Vol.77 (3), p.716-720
Main Authors: Eassa, Waleed, Jednak, Roman, Capolicchio, John Paul, Brzezinski, Alex, El-Sherbiny, Mohamed
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Child
Child, Preschool
Humans
Hypospadias - surgery
Infant
Male
Medical sciences
Nephrology. Urinary tract diseases
Postoperative Complications
Reoperation
Urethra - surgery
Urologic Surgical Procedures, Male - adverse effects
Urologic Surgical Procedures, Male - methods
Urology
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Summary:Objectives To review our 10-year experience with tubularized incised-plate (TIP) urethroplasty and determine the risk factors for reoperation. Methods The hospital records of 391 patients underwent the TIP procedure from April 1997 to September 2007 were reviewed retrospectively. Data were collected with respect to patient demographics, characteristics of the hypospadias malformation, intraoperative factors and postoperative outcome. Complications requiring reoperation were identified. Univariate and multivariate analyses were used to identify risk factors for reoperation. Results Median age at surgery was 2 years (range, 0.5-16). Median follow-up was 11 months (range, 3-96). Neourethral complications requiring re-operation developed in 48 patients. A total of 52 reoperations were required because of fistulae (25/6%), neourethral disruption (13/3%), meatal stenosis (13/3%), and stricture (1/0.3%). The re-operation rate was significantly higher in the presence of interrupted sutures, chordee requiring dorsal plication, penoscrotal or proximal shaft defects, a lack of neourethral vascular tissue coverage, and in children over 4 years of age. Multivariate analysis identified the last 3 of these variables as independent risk factors for reoperation. Conclusions In addition to position of the urethral meatus and the absence of vascular covering flaps, we found that an age over 4 years at the time of surgery is an additional independent risk factor for neourethral complications requiring reoperation.
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2010.07.467