International Urology and Nephrology

, Volume 46, Issue 3, pp 487–491 | Cite as

Comparative outcomes of the tubularized incised plate and transverse island flap onlay techniques for the repair of proximal hypospadias

  • Ning Xu
  • Xue-Yi XueEmail author
  • Xiao-Dong Li
  • Yong Wei
  • Qing-Shui Zheng
  • Tao Jiang
  • Jin-Bei Huang
  • Xiong-Lin Sun
Urology - Original Paper



The optimal management of proximal hypospadias remains uncertain. In this study, the surgical outcomes of tubularized incised plate repair (TIP) and transverse island flap (TVIF) onlay urethroplasty in boys with hypospadias were compared.


A total of 176 patients with proximal hypospadias underwent TIP (n = 83) or TVIF onlay repairs (n = 93) by a single surgeon and were evaluated retrospectively. No patient received a testosterone injection prior to surgery. A retrospective review of their medical records collected data regarding age at surgery, chordee, dorsal plication, hypospadias site, penoscrotal transposition, bifid scrotum, congenital hernia, undescended testis and any postoperative complications, including fistula, recurrent curvature, dehiscence, diverticulum, meatal stenosis and urethral stricture. The pediatric penile perception score (PPPS) was completed by parents to evaluate their perception of cosmetic outcomes.


There was no statistical difference in age or any of the anatomical and clinical features of hypospadias. The median follow-up duration was 22 months (range 12–48 months) and 25 months (14–51 months) for the TIP and TVIF onlay groups, respectively. The overall complication rate in the TVIF onlay group was 21.5 % (20/93), which was higher than 18.1 % (15/83) in the TIP group, but the difference was not statistically significant (P = 0.569). The most common complication was urethrocutaneous fistula, occurring in 9.6 % (8/83) of the TIP group and 10.8 % (10/93) of the TVIF onlay group. There were no significant differences in the rate of any complication and the overall PPPS between the two groups.


TIP and TVIF onlay are clinically equivalent for the repair of proximal hypospadias.


Hypospadias Tubularized incised plate repair Transverse island flap onlay 



This work was supported by grants from the Youth Foundation of Fujian Province Department of Health (2009-2-16), the Professorial Development Foundation of Fujian Medical University (JS10017) and the Natural Science Foundation of Fujian Province (2012J01340).

Conflict of interest

The authors have no conflicts of interest to declare.


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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Ning Xu
    • 1
  • Xue-Yi Xue
    • 1
    Email author
  • Xiao-Dong Li
    • 1
  • Yong Wei
    • 1
  • Qing-Shui Zheng
    • 1
  • Tao Jiang
    • 1
  • Jin-Bei Huang
    • 1
  • Xiong-Lin Sun
    • 1
  1. 1.Department of UrologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouPeople’s Republic of China

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