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Systematic review and meta-analysis of studies comparing the perimeatal-based flap and tubularized incised-plate techniques for primary hypospadias repair

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Abstract

Purpose

To conduct a systematic review and meta-analysis of studies comparing the perimeatal-based flap (PBF) and tubularized incised-plate (TIP) techniques for primary hypospadias repair and determine whether the two techniques had similar reported outcomes.

Methods

The PubMed, Embase and Cochrane databases were searched using the terms: hypospadias, Snodgrass, TIP*, tubularized incised plate, tubularized incised-plate, Mathieu*, perimeatal-based flap, perimeatal flap, meatal-based flap and meatal based flap. No other limits were used. Inclusion criteria included: primary hypospadias repair only; both including the PBF and TIP techniques; at least one of the quantitative outcomes obtainable from study; comparative studies.

Results

Twelve studies fulfilled the inclusion criteria and were included in the final analysis. Meta-analysis showed that there were no significant differences between the two techniques when comparing fistula (OR = 1.47; 95 % CI: 0.82–2.63; P = 0.20), meatal stenosis (OR = 0.53; 95 % CI: 0.24–1.16; P = 0.11), and wound dehiscence (OR = 0.82; 95 % CI: 0.24–2.84; P = 0.76). Both the studies which assessed cosmesis objectively showed a consistent better cosmetic result of the TIP technique (P < 0.05).

Conclusion

There were no significant differences of complication rates between the two techniques, and the TIP technique was usually of better cosmesis. Given the large clinical heterogeneity among studies, future more well-designed studies with full data and uniform criterion were awaited.

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Acknowledgments

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Conflict of interest

The authors have declared no conflicts of interest.

Author information

Authors and Affiliations

  1. Ningbo Women and Children’s Hospital, No. 339 Liuting Street, Ningbo, Zhejiang, 315012, People’s Republic of China

    Furan Wang, Yinghua Xu & Hongji Zhong

Authors
  1. Furan Wang
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  2. Yinghua Xu
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  3. Hongji Zhong
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Corresponding author

Correspondence to Furan Wang.

Additional information

F. Wang, Y. Xu and H. Zhong are joint first authors and contributed equally to the paper.

Appendix Search strategy used in the systematic search

Appendix Search strategy used in the systematic search

PubMed:

Hypospadias[mh] AND (Snodgrass OR TIP* OR “tubularized incised plate” OR “tubularized incised-plate”) AND (“perimeatal-based flap” OR Mathieu* OR “perimeatal flap” OR “meatal-based flap” OR “meatal based flap”).

EMBase:

‘Hypospadias’/exp AND (Snodgrass OR tip* OR ‘tubularized incised plate’ OR ‘tubularized incised-plate’) AND (‘perimeatal-based flap’ OR Mathieu OR ‘perimeatal flap’ OR ‘meatal-based flap’ OR ‘meatal based flap’).

Cochrane:

Hypospadias AND (Snodgrass OR TIP OR “tubularized incised plate” OR “tubularized incised-plate”) AND (“perimeatal-based flap” OR Mathieu OR “perimeatal flap” OR “meatal-based flap” OR “meatal based flap”).

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Wang, F., Xu, Y. & Zhong, H. Systematic review and meta-analysis of studies comparing the perimeatal-based flap and tubularized incised-plate techniques for primary hypospadias repair. Pediatr Surg Int 29, 811–821 (2013). https://doi.org/10.1007/s00383-013-3335-3

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  • DOI: https://doi.org/10.1007/s00383-013-3335-3

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