Re-operative Hypospadias Repair Using Tubularized Incised Plate Urethroplasty

The aim of this study is to evaluate the outcomes, feasibility, and complication profile of re-operative hypospadias repair using tubularized incised plate urethroplasty as a single-stage procedure in a single-center experience.

Study Overview

• Status: Completed
• Conditions: Hypospadias; Tubularized Incised Plate; Urethroplasty; Re-operative
• Intervention / Treatment: Procedure: Tubularized Incised Plate Urethroplasty

Detailed Description

Hypospadias repair remains one of the most common reconstructive procedures in pediatric urology; however, re-operative hypospadias represents a challenging subset due to distorted anatomy, urethral plate scarring, deficient local tissues, and higher complication rates compared with primary repairs.

The tubularized incised plate (TIP) urethroplasty, originally described by Snodgrass, revolutionized primary hypospadias repair and has since been adapted for selected reoperative cases. Contemporary evidence suggests that despite prior surgery and scary, a well-vascularized urethral plate of adequate width can still be successfully tubularized following a midline relaxing incision, offering acceptable functional and cosmetic outcomes.

• Study Type: Observational
• Enrollment (Actual): 15

Contacts and Locations

Study Locations

• Egypt
  • El-Gharbia
    • Tanta, El-Gharbia, Egypt, 31527
      • Tanta University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

We will conduct a retrospective review of 15 pediatric cases who presented or referred with complications requiring reoperation after primary hypospadias repair, including urethrocutaneous fistula, meatal stenosis, or poor urinary stream. This study will be conducted at Tanta university hospitals from January 2021 to december 2025. The data will be collected from 1st January 2026 to 1st February 2026.

Description

Inclusion Criteria:

• Both sexes.
• Children with recurrent or residual hypospadias in whom the urethral plate is deemed suitable for reuse, defined as a plate width of at least 8-9 mm with acceptable vascularity and without severe fibrosis.

Exclusion Criteria:

• Patients with severely scared or fibrotic urethral plates are not suitable for tubularization.
• Absent or destroyed urethral plates following previous failed hypospadias repairs.
• Patients require staged urethral reconstruction rather than a single-stage procedure.
• Presence of poor urethral plate vascularity or ischemic tissue.
• Extensive penile scarring or fibrosis resulting from multiple previous surgical attempts.
• Severe penile curvature requiring excision of the urethral plate.
• Inability to achieve adequate, well-vascularized tissue coverage over the neourethra.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Study group; Children with recurrent or residual hypospadias in whom the urethral plate is deemed suitable for reuse.

Procedure: Tubularized Incised Plate Urethroplasty; All procedures were performed under general anesthesia using the tubularized incised plate technique. After completing penile degloving and exposure of the urethral plate, a midline longitudinal incision was made along the entire length of the plate to allow tension-free tubularization. The urethral plate was then tubularized over an appropriate-sized urethral catheter using fine absorbable sutures. A well-vascularized dartos flap was harvested and interposed as a protective layer over the neourethra, followed by meticulous skin closure.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Success rate	The success rate of tubularized incised plate urethroplasty reoperation after treatment was recorded.	6 months after the procedure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of complications	Incidence of postoperative complications such as fistula, meatal stenosis, glans dehiscence, and urethral stricture were recorded.	6 months after the procedure
Incidence of postoperative urethrocutaneous fistula	Incidence of postoperative urethrocutaneous fistula was recorded.	6 months after the procedure
Incidence of meatal stenosis	Incidence of meatal stenosis was recorded.	6 months after the procedure

Collaborators and Investigators

• Sponsor: Tanta University

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2021
• Primary Completion (Actual): December 1, 2025
• Study Completion (Actual): December 1, 2025

Study Registration Dates

• First Submitted: February 14, 2026
• First Submitted That Met QC Criteria: February 14, 2026
• First Posted (Actual): February 20, 2026

Study Record Updates

• Last Update Posted (Actual): February 20, 2026
• Last Update Submitted That Met QC Criteria: February 14, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Urogenital Diseases; Genital Diseases; Genital Diseases, Male; Male Urogenital Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Congenital Abnormalities; Urogenital Abnormalities; Penile Diseases; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Hypospadias
• Other Study ID Numbers: 36264PR1310136/1/26

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No