THE IMPORTANCE OF URETHRAL PLATE IN HYPOSPADIAS SURGERY AND TUBULARISED INCISED PLATE URETHROPLASTY (TIPU)

Abstract

Abstract

Introduction: The approach to hypospadias surgery has changed over the past ten years since the

identification of the urethral plate as an anatomical entity. A number of surgical procedures have been

described using the urethral plate to correct coronal,distal-middle and proximal shaft hypospadias. Thiersch-

Duplay, the glans approximation procedure (GAP) and pyramid repair all involve simple tubularization of the

deep glandular cleft and the deeply grooved urethral plate. Most of the time, the ventral glans and urethral

plate do not have a groove deep enough for simple tubularisation of the urethral plate. The tubularised incised

plate urethroplasty (TIPU) procedure is described for such cases to correct the defect without using additional

skin flaps. The final appearance is a vertically oriented, slit-like meatus with excellent cosmetic results and

very few complications. Nowadays TIPU is the preferred method for correcting many of the hypospadias

cases, even for the very proximal and re-do ones. A brief review about the technique, tricks, complications and

the results of the procedure is presented.