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Abstract
Our study was conducted over 30 patients with 17 anterior and 13 middle hypospadias; 24 of them were primary and 6 recurrent cases. In the period in between May 2004 and May 2005. Patient ages ranged from 1.5 to 14 years with mean of 3.5 years. Positive family history founded in 4 cases; 2 for a brother and one for the father and male cousin. Penile chordee was present in 6 patients (20%) and associated congenital anomalies (inguinal hernia and undescended testis) were founded in 3 cases.
All of them were operated by TIP urethroplasty according to the modification reported by Jayanthi (2003) with addition of subcutaneous flap in 18 cases and tunica vaginalis flap in 12 cases as a second layer coverage of the neourethra to minimize the risk of urethral fistula. Operative time ranged from 70 to 110 minutes which was longer in middle than in anterior and when tunica vaginalis used than when dartos used. Postoperative hospitalization period ranged from one day to 10 days with mean of 2 days. Most of our cases need from one day to 3 days. Complicated cases need longer time. Minor complications occurred in 5 patients and were 7 in number, the commonest of them was penile skin edema in 3 cases. All minor complications respond to management but in 3 of them, major complication occurred. Follow up in our study ranged from 3 to 9 months with mean of 6 months.
During follow up, recording of complication, calibration and regular dilation of the meatus and urethra in cases of meatal stenosis, urethral stricture and small single fistulas was done in early postoperative period complicated cases were 7/30 (23.33%) with 11 complications. The commonest of them were fistulas and meatal stenosis 5 and 3 respectively. After the end of follow up, the complicated cases decreased to 4/30 (13.33%) with 6 complications. Cosmotic appearance was good in nearly all patients.