Short-Term Surgical Outcomes: Modified Dorsal Inlay Graft Versus Tubularized Incised Plate Urethroplasty in Pediatric Hypospadias With Narrow Urethral Plates.

BACKGROUND

Reconstructing the urethra presents in hypospadias surgery is difficult. Occasionally, the urethral plate (UP) may be quite narrow, necessitating augmentation or replacement to achieve additional tubularization.

OBJECTIVE

The objective of this research was to assess the application of modified dorsal inlay graft (mDIG) and tubularized incised plate (TIP) urethroplasties in patients with hypospadias and narrow UPs and to determine which method yields superior functional and surgical outcomes.

MATERIALS AND

METHODS

The medical records of 114 patients with distal/midshaft hypospadias and narrow UPs who were treated at our hospital from December 2020 to June 2024 were analyzed in this retrospective cohort study. These individuals were categorized into two distinct groups: the TIP and the mDIG groups. Standard preoperative characteristics, surgical technique, postoperative complication rate, maximum urinary flow rate (Qmax), and the hypospadias objective scoring evaluation (HOSE) score were analyzed to assess treatment efficacy in both groups.

RESULTS

No significant differences in patient age, meatus location, UP width, coronal diameter, or urethral length were observed between the two groups. Sixty-five patients (57.0%) underwent TIP urethroplasty, and 49 patients (43.0%) underwent mDIG urethroplasty. A statistically significant difference in operative time was observed, with operative times of 108 (101-118.5) and 85 (78-92.5) min (p < 0.001) in the mDIG and TIP groups, respectively. The mDIG group demonstrated a better HOSE score than the TIP group, with 5 (10.2%) versus 18 (27.7%) patients scoring less than 16 points and 44 (89.8%) patients versus 47 (72.3%) scoring 16 points, respectively. Three months after surgery, the Qmax was 11.7 ± 3.4 mL/s in the mDIG group versus 9.43 ± 3.1 mL/s in the TIP group (p < 0.05).

DISCUSSION AND

CONCLUSION

mDIG urethroplasty has a high success rate, ensuring both optimal aesthetic and functional outcomes in the short term, which, justifies the additional operative time.