Outcome of Tubularized Incised Plate (TIP) Urethroplasty in Distal Penile Hypospadias in Pediatric Patients.

Abstract

Background: Tubularized incised plate (TIP) urethroplasty is widely regarded as a preferred technique for the correction of distal penile hypospadias due to its technical simplicity, reliability, and favourable cosmetic outcomes. However, surgical results may vary depending on tissue characteristics and operative factors. This study aimed to evaluate the functional and cosmetic outcomes, as well as the complication profile, of TIP urethroplasty in paediatric patients with distal penile hypospadias.

Methods: A prospective observational study was conducted involving 71 paediatric patients with primary distal penile hypospadias who underwent TIP urethroplasty between January 2019 and August 2025. Preoperative characteristics, intraoperative details, and postoperative outcomes were recorded. Cosmetic outcomes were assessed using the Hypospadias Objective Scoring Evaluation (HOSE) system, while parental satisfaction was evaluated through structured feedback. Statistical analysis was performed using SPSS, with a significance level set at p < 0.05.

Results: The mean age at surgery was 2.9 ± 1.4 years. Coronal hypospadias was the most common subtype (45.1%), and chordee was present in 25.4% of patients. Urethrocutaneous fistula occurred in 8.5% of cases, while meatal stenosis (5.6%) and glans dehiscence (2.8%) were less frequent. Poor urethral plate quality was significantly associated with fistula formation (p = 0.013). Good cosmetic outcomes (HOSE score ≥14) were achieved in 88.7% of patients, and 85.9% of parents reported satisfaction with the surgical results. Reoperation was required in 9.9% of cases.

Conclusion: TIP urethroplasty is a safe and effective option for the management of distal penile hypospadias in children. Careful assessment of urethral plate quality and meticulous surgical technique are essential to minimize complications and optimize outcomes.