Cosmetic Outcome of Tubularized Incised Plate Depends on The Type of Hypospadias: A Case Control Study

摘要

Background: Recent studies show Tubularized Incised Plate (TIP) urethroplasty, commonly used for distal hypospadias repair, can be used in proximal hypospadias with a decent success rate. It was contented that the age of the patient when undertook the surgery influences the outcome, with young age gaining more favourable outcome than the older. One the objectives of hypospadias repair is the cosmetic outcome, which can be evaluated using Hypospadias Objective Penile Evaluation (HOPE) questionnaires. Our objective is to compare the proportion of the young and the older patients based on the cosmetic surgical outcome. Methods: In Sanglah General Hospital, Denpasar, 38 patients who had undergone a TIP urethroplasty from January 2012 until December 2015 were evaluated using HOPE questionnaires. Results: The sample are divided into two equally-numbered groups based on the HOPE total score. The median of the age of the subjects when they undergone the surgery is 4.8 years (1.89-18.10). The proportion of the over 5 year old in the cosmetically unsatisfying group (case) is the same as the proportion in the cosmetically satisfying group (control), 52.63%, EOR=1 (p>0.05). The proportion based on the year of surgery are different, but not statistically significant (p>0.05). Based on the type of hypospadias, the proportion of subjects with proximal hypospadias in the case group is more than in the control group, EOR=14.95 (p<0.05). It shows proximal hypospadias is a risk factor for cosmetically unsatisfying result post TIP urethroplasty. Conclusions: It should be taken into account that TIP in proximal hypospadias has a greater risk to produce an unsatisfying cosmetical result.