Flap Method is Better Than the Tubularized Incised Plate Method for the Surgical Treatment of Distal Hypospadias

Gede Wirya Kusuma Duarsa; Samuel Denny Lawanto; Anak Agung Gde Oka; Kadek Budi Santosa; I Wayan Yudiana; Pande Made Wisnu Tirtayasa; Ida Bagus Putra Pramana; Christopher Ryalino

doi:10.3889/oamjms.2020.3246

Authors

Gede Wirya Kusuma Duarsa Department of Surgery, Division of Urology Surgery, Faculty of Medicine, Udayana University, Bali, Indonesia
Samuel Denny Lawanto Department of Surgery, Faculty of Medicine, Udayana University, Bali, Indonesia
Anak Agung Gde Oka Department of Surgery, Division of Urology Surgery, Faculty of Medicine, Udayana University, Bali, Indonesia
Kadek Budi Santosa Department of Surgery, Division of Urology Surgery, Faculty of Medicine, Udayana University, Bali, Indonesia
I Wayan Yudiana Division of Urology, Department of Surgery, Faculty of Medicine Universitas Udayana, Bali, Indonesia
Pande Made Wisnu Tirtayasa Department of Surgery, Division of Urology Surgery, Faculty of Medicine, Udayana University, Bali, Indonesia
Ida Bagus Putra Pramana Department of Surgery, Division of Urology Surgery, Faculty of Medicine, Udayana University, Bali, Indonesia
Christopher Ryalino Department of Anesthesia and Intensive Care, Faculty of Medicine, Udayana University, Bali, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.3246

Keywords:

hypospadia, urethroplasty, complication, meatal stenosis, urinary stream

Abstract

BACKGROUND: Urethroplasty techniques generally can be divided into two methods, the flap method (Mathieu and Onlay Flap) and no flap with tubularized incised plate (TIP) urethroplasty method. Complications are common after urethral reconstructioninclude urethrocutaneous fistulae and cosmetic appearance, which is usually measured by Hypospadias Objective Penile Evaluation (HOPE) scoring system.

AIM: The aim of this study was to determine whether there are differences in the outcome of flap method compare to TIP method in distal hypospadias patients who underwent urethroplasty.

PATIENTS AND METHOD: The subjects of this study were patients with distal hypospadias who underwent urethroplasty in Sanglah General Hospital from September 2017 to December 2017. Thirty-six samples were selected by consecutive sampling.

RESULTS: The results showed a significant difference in the incidence of meatal stenosis (p = 0.05) and urinary stream disturbances(p = 0.05) between two methods. No significant differences were found in the incidence of urethrocutaneous fistulae (p = 0.500) and the unsatisfactory HOPE score (p = 0.169).

CONCLUSION: This research showed that meatal stenosis andthe maximum urinary stream were better in flap method compared to TIP method in distal hypospadias patients underwent urethroplasty.

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