# Complications of Tubularized Incised Plate Urethroplasty and Spongioplasty Repair in Hypospadias

## TL;DR

This study examines the short-term complications of a common surgical repair for hypospadias in children, finding a low overall complication rate with urethrocutaneous fistula being the most common issue.

## Contribution

The study provides new data on complication rates of TIPS repair for distal hypospadias in a specific pediatric population.

## Key findings

- Urethrocutaneous fistula occurred in 5.45% of patients.
- Urethral stricture occurred in 1.8% of patients.
- No cases of meatal stenosis or chordee recurrence were observed.

## Abstract

Background

Hypospadias is a common congenital anomaly in males, typically presenting with a ventrally displaced urethral meatus, incomplete prepuce, and chordee. Among over 300 surgical techniques described, the tubularized incised plate (TIP) urethroplasty with spongioplasty (TIPS), also known as the Snodgrass repair, is widely preferred for distal hypospadias due to its functional and aesthetic outcomes.

Objective

This study aims to determine the short-term complications of TIPS repair in pediatric patients with distal hypospadias.

Methods

A cross-sectional study was conducted at the department of burns, plastic and reconstructive surgery, Northwest General Hospital & Research Center, Peshawar, Pakistan, from June 2022 to March 2023. A total of 113 male patients (aged 18 months to 12 years) with distal hypospadias and a urethral plate width greater than 8 mm were included; 110 completed follow-up. Patients with proximal hypospadias or severe chordee were excluded. Postoperative complications were assessed over a minimum follow-up of three months.

Results

Of 110 patients, eight (7.27%) developed complications. Urethrocutaneous fistula (UCF) was the most common, occurring in six patients (5.45%), followed by urethral stricture in two (1.8%). No cases of meatal stenosis or chordee recurrence were observed. A statistically significant association was found between complications and both fistula (p = 0.0001) and stricture (p = 0.002).

Conclusion

TIPS repair is a safe and effective surgical option for distal hypospadias, demonstrating low short-term complication rates. UCF remains the most prevalent postoperative issue. Further long-term, multicenter studies are warranted.