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Urethral compliance in hypospadias operated by tubularized incised urethral plate (TIP) with and without a dorsal inlay graft: an experimental controlled study

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Abstract

Objective

Abnormal uroflowmetries are common after tubularized incised plate urethroplasties (TIP), perhaps due to low compliance. We hypothesized that (1) abnormal uroflowmetries after TIP might be caused by segmental lower compliance; (2) by adding a graft to the raw area in the incised plate (TIPG), compliance might be improved by preventing secondary intention healing of the dorsal incision.

Methods

A standardized penectomy was performed in 27 adult male rabbits: 9 normal non-operated controls (G1), 6 weeks after TIP (G2: n = 9) or TIPG (G3: n = 9). A standardized isolated segment (including the whole urethroplasty in G1 and G2) was progressively distended with air (1, 2 and 3 ml) in the 3 groups. The respective intraluminal pressures were measured with a tensiometer.

Results

Pressure measurements were feasible and reproducible for this model. Mean pressures tended to be higher in the experimental groups (G1: 59.7 mmHg vs. G2: 79.6 mmHg vs. G3: 100.1 mmHg for 1 ml injections; G1: 233.1 mmHg vs. G2: 241 mmHg vs. G3: 308.4 mmHg for 2 ml injections and G1: 457.3 mmHg vs. G2: 429 mmHg vs. G3: 520 mmHg for 3 ml injections) without reaching the statistical significance.

Conclusion

In this model, the elasticity of the TIP or TIPG neourethras tended to be reduced when compared to controls. The placement of an inlay graft on the dorsal incised area did not increase the compliance. This model allows the measurement of segmental intraluminal urethral pressures generated by controlled air distension and may be a useful tool to evaluate the experimental urethroplasty models.

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Abbreviations

TIP:

Tubularized incised plate urethroplasty

NUP:

Neourethroplasty

TIPG:

Tubularized incised plate urethroplasty with dorsal inlay preputial graft

UPP:

Urethral pressure profiles

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Acknowledgments

Paula Pflugfelder and Marvin Estrada, Experimental Surgery Department, The Hospital for Sick Children, Toronto University, Toronto, Canada.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Center for Experimental Surgery, Post-Graduation in Surgical Sciences, CAPES, CNPq, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    L. E. Jesus & A. Schanaider

  2. Division of Pediatric Surgery and Pediatric Urology, Department of Surgery, Federal Fluminense University and Servidores do Estado Hospital, Rio de Janeiro, Brazil

    L. E. Jesus

  3. Biomedical Engineering Department, The Hospital for Sick Children, Toronto University, Toronto, Canada

    G. Patterson

  4. Division of Pediatric Urology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

    A. Marchenko, K. J. Aitken, B. Leslie, D. J. Bagli & J. L. Pippi-Salle

  5. Division of Developmental and Stem Cell Biology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

    D. J. Bagli

  6. Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, 52 Presidente Domiciano St, apt 801. Niterói, Rio de Janeiro, CEP 24210-270, Brazil

    L. E. Jesus

Authors
  1. L. E. Jesus
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  2. A. Schanaider
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  3. G. Patterson
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  5. K. J. Aitken
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  6. B. Leslie
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  7. D. J. Bagli
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  8. J. L. Pippi-Salle
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Correspondence to L. E. Jesus.

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Jesus, L.E., Schanaider, A., Patterson, G. et al. Urethral compliance in hypospadias operated by tubularized incised urethral plate (TIP) with and without a dorsal inlay graft: an experimental controlled study. World J Urol 31, 971–975 (2013). https://doi.org/10.1007/s00345-012-1004-0

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  • DOI: https://doi.org/10.1007/s00345-012-1004-0

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