A modification of the TIP procedure for distal hypospadias: The burrowing technique

Authors

  • Erin D. Wishart University of Alberta
  • Peter D. Metcalfe Department of Surgery, Division of Urology, University of Alberta

DOI:

https://doi.org/10.5489/cuaj.1677

Keywords:

TIP, hypospadias, Snodgrass

Abstract

Introduction: The tubularized incised plate urethroplasty (TIP) hypospadias repair is a commonly performed procedure for hypospadias. Multiple series document excellent cosmetic outcome in conjunction with low complication rates. We describe a modification that we have named the “burrowing technique.” We believe that this technique facilitates dissection of the glans, which improves mobility, decreases tension with closure, and potentially improves outcomes.

Methods: A retrospective review was performed of 193 coronalor mid-shaft hypospadias repairs by a single surgeon. The first 98 were performed using the TIP procedure, then the burrowing technique was developed and a subsequent 95 were analyzed for outcomes using this modification. Urethral plate characteristics and glandular size did not influence the choice of surgical technique. Cases were selected to allow for a “learning curve,” and were consecutively accrued. None of the boys had undergone prior hypospadias surgery. Proximal 2 stage repairs and distal (glanular) repairs were excluded.

Results: A total of 193 boys underwent repair, 98 with the traditional TIP procedure and 95 using the burrowing modification. In total, 37 (19.2%) patients required re-operation for either fistulas or dehiscence; 23 (23.5%) in the non-burrowing group and 14 (14.7%) in the burrowing group, odds ratio 0.54 (p = 0.10).

Conclusions: The TIP procedure has revolutionized the management of distal hypospadias. The burrowing modification increases glandular mobility simplifying the procedure and demonstrates a non-statistically significant trend in reducing reoperation rates.

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Author Biography

Erin D. Wishart, University of Alberta

University of Alberta

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Published

2014-06-19

How to Cite

Wishart, E. D., & Metcalfe, P. D. (2014). A modification of the TIP procedure for distal hypospadias: The burrowing technique. Canadian Urological Association Journal, 8(5-6), e425–8. https://doi.org/10.5489/cuaj.1677

Issue

Vol. 8 No. 5-6 (2014): CUAJ June

Section

Original Research

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