International Urology and Nephrology

, Volume 49, Issue 12, pp 2099–2104 | Cite as

Modified tubularized incised plate urethroplasty reduces the risk of fistula and meatal stenosis for proximal hypospadias: a report of 63 cases

  • Hamid Arshadi
  • Shabnam Sabetkish
  • Abdol-Mohammad KajbafzadehEmail author
Urology - Original Paper



To report the feasibility of modified tubularized incised plate (TIP) urethroplasty technique for proximal hypospadias in 63 cases.


From January 2004 to March 2010, 63 patients underwent one-stage TIP urethroplasty (modified Snodgrass technique repair) using 2–3 of three covering layers (corpus spongiosum, dartos, and tunica vaginalis). The primary meatus was proximal penile, penoscrotal, scrotal, and perineal in 38, 13, 10, and 2 patients, respectively. All patients had chordee that was corrected with dorsal plication. Glanuloplasty was performed in all cases. Complications and cosmetic results were documented after 6–72 months of follow-up.


A total of 63 boys with proximal hypospadias underwent Snodgrass hypospadias repair at a mean age of 8.5 months (range 6–54). Mean operative time was 210 ± 35 min. Patients were followed up with 6-month intervals for up to 6 years postoperatively. After 6 years of follow-up, nine urethrocutaneous fistulae, four bleeding, four meatal stenoses, and one urethral stricture were reported. Cosmetic result was satisfactory according to parent’s opinion and another surgeon. No residual chordee was observed in any cases (without artificial correction).


In conclusion, this preliminary report can be estimated as an alternative technique with acceptable complication and cosmetic results for proximal hypospadias correction.


Tubularized incised plate urethroplasty Proximal hypospadias Fistula Meatal stenosis Complication Cosmetic 



Modified tubularized incised plate


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplementary material 1 (MP4 9383 kb)

Supplementary material 2 (MP4 7934 kb)

Supplementary material 3 (MP4 3606 kb)


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Hamid Arshadi
    • 1
  • Shabnam Sabetkish
    • 1
  • Abdol-Mohammad Kajbafzadeh
    • 1
    Email author
  1. 1.Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children’s Hospital Medical CenterTehran University of Medical SciencesTehranIran

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