Short-Term Outcomes of Tubularized Incised Plate Urethroplasty and Associated Factors Among Children with Hypospadias at a Zonal Level Hospital, Lake Zone – Tanzania

Erasto Wambura; Seth Jotham; Simula Flavian; Igenge John; Arda Francia

doi:10.37284/eajhs.8.1.3063

Erasto Wambura Muhimbili National Hospital
Seth Jotham St. Francis University College of Health and Allied Sciences
Simula Flavian Catholic University of Health and Allied Sciences
Igenge John Catholic University of Health and Allied Sciences
Arda Francia Muhimbili University of Health and Allied Sciences

DOI: https://doi.org/10.37284/eajhs.8.1.3063

Sambaza Makala:

Ikisiri

Background: Hypospadias is an anatomical congenital abnormality characterized by an abnormal development of the urethra fold with a ventral malposition of the urethra opening. Tubularized Incised Plate Urethroplasty (TIPU) is among the repair techniques that are not short of complications. Methodology: This was a cross-sectional study with a prospective component conducted in the Urology department from January 2023 to June 2023 with the aim to determine the short-term outcomes of Tubularized Incised Plate Urethroplasty and associated factors among children with hypospadias at Bugando Medical Centre. Children at the age of 4 months to 15 years of age were included in the study after TIPU. STATA version 15.0 was used for analysis as per the objectives of the study. With the use of the Chi-square test, a P-value of < 0.05 was considered to be significant. Results: 90 patients were included in the study with a median age of 2.25 years, the age of patients were grouped into two groups, <2 years and >2 years of age. After TIPU, patients were followed - up for 1 month. Glandular hypospadias was in 40 (44.44%) patients, coronal in 29 (32.22%), subcoronal in 15 (16.67%), distal penile in 4 (4.44%), and midshaft in 2 (2.22%) patients. While other factors did not show any association with the outcomes of interest, hypospadias sites were significantly associated with complications (P value = 0.029). Conclusion. TIPU is a simple and effective technique for hypospadias repair in children. This study has shown a significant association between interventional complications and site of malformation. With supplementary factors in question, the authors recommend other large multicenter studies to cover the facet of all practical attributes of different techniques currently in place.

Upakuaji

Bado hatuna takwimu za upakuaji.

Marejeleo

Aaronson, I. A., Cakmak, M. A., & Key, L. L. (1997). Defects of the testosterone biosynthetic pathway in boys with hypospadias. The Journal of Urology, 157(5), 1884-1888.

Ahmad, R., Chana, R. S., Ali, S. M., & Khan, S. (2011). Role of parenteral testosterone in hypospadias: A study from a teaching hospital in India. Urology annals, 3(3), 138–140.

Alshafei, A., Cascio, S., Boland, F., O'Shea, N., Hickey, A., & Quinn, F. (2020). Comparing the outcomes of tubularized incised plate urethroplasty and dorsal inlay graft urethroplasty in children with hypospadias: a systematic review and meta-analysis. Journal of Pediatric Urology, 16(2), 154–161.

Appeadu-Mensah, W., Hesse, A. A. J., Glover-Addy, H., Osei-Nketiah, S., Etwire, V., & Sarpong, P. A. (2015). Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country. African journal of paediatric surgery, 12(4), 211-216.

Arendt, L. H., Ernst, A., Lindhard, M. S., Jønsson, A. A., Henriksen, T. B., Olsen, J., & Ramlau-Hansen, C. H. (2017). Accuracy of the hypospadias diagnoses and surgical treatment registrations in the Danish National Patient Register. Clinical epidemiology, 483-489.

Baskin L. S. (2000). Hypospadias and urethral development. The Journal of Urology, 163(3), 951–956.

Bhat, A., & Mandal, A. K. (2008). Acute postoperative complications of hypospadias repair. Indian Journal of Urology, 24(2), 241-248.

Brouwers, M. M., Feitz, W. F., Roelofs, L. A., Kiemeney, L. A., De Gier, R. P., & Roeleveld, N. (2007). Risk factors for hypospadias. European journal of pediatrics, 166, 671-678.

Chen, S. C., Yang, S. S. D., Hsieh, C. H., & Chen, Y. T. (2000). Tubularized incised plate urethroplasty for proximal hypospadias. BJU international, 86(9), 1050-1053.

Donaire, A. E., & Mendez, M. D. (2023). Hypospadias. In StatPearls. StatPearls Publishing.

Duckett Jr, J. W., Kaplan, G. W., Woodard, J. R., & Devine Jr, C. J. (1980). Panel: complications of hypospadias repair. The Urologic Clinics of North America, 7(2), 443-454.

Eliçevik, M., Tireli, G., & Sander, S. (2004). Tubularized incised plate urethroplasty: 5 years’ experience. European Urology, 46(5), 655-659.

Fernandez, N., Escobar, R., & Zarante, I. (2016). Craniofacial anomalies associated with hypospadias. Description of a hospital-based population in South America. International braz j urol, 42, 793-797.

Fredell, L., Kockum, I., Hansson, E., Holmner, S., Lundquist, L., Läckgren, G., & NORDENSKJÖLD, A. (2002). Heredity of hypospadias and the significance of low birth weight. The Journal of Urology, 167(3), 1423-1427.

Güler, Y. (2020). TIPU outcomes for hypospadias treatment and predictive factors causing urethrocutaneous fistula and external urethral meatus stenosis in TIPU: Clinical study. Andrologia, 52(9), e13668.

Horowitz, M., & Salzhauer, E. (2006). The ‘learning curve’ in hypospadias surgery. BJU International, 97(3), 593-596.

Keays, M. A., & Dave, S. (2017). Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes. Canadian Urological Association Journal, 11(1-2Suppl1), S48.

Kilasi, Jacqueline, Seth Jotham, Vihar Kotecha, and Philipo Chalya. "Prevalence of Malnutrition and its Association with Early Outcomes among Adult Patients Undergoing Abdominal Surgery Admitted at Bugando Medical Centre, Mwanza, Tanzania." (2024).

Özman, O., Kuru, M., Gezer, M., Gevher, F., & Önal, B. (2019). Outcomes of Hypospadias Surgery Performed by Different Surgeons Under the Supervision of an Experienced Pediatric Urology Surgeon.

Paulozzi, L. J., Erickson, J. D., & Jackson, R. J. (1997). Hypospadias trends in two US surveillance systems. Pediatrics, 100(5), 831-834.

Sarhan, O. M., El-Hefnawy, A. S., Hafez, A. T., Elsherbiny, M. T., Dawaba, M. E., & Ghali, A. M. (2009). Factors affecting outcome of tubularized incised plate (TIP) urethroplasty: single-center experience with 500 cases. Journal of Pediatric Urology, 5(5), 378-382.

Snodgrass, W. T., Bush, N., & Cost, N. (2010). Tubularized incised plate hypospadias repair for distal hypospadias. Journal of pediatric urology, 6(4), 408-413.

Snodgrass, W., & Bush, N. C. (2017). Re-operative urethroplasty after failed hypospadias repair: how prior surgery impacts risk for additional complications. Journal of pediatric urology, 13(3), 289-e1.

Springer, A., van den Heijkant, M., & Baumann, S. (2016). Worldwide prevalence of hypospadias. Journal of pediatric urology, 12(3), 152-e1.

Viseshsindh, W. (2014). Factors affecting results of hypospadias repair: single technique and surgeon. J Med Assoc Thai, 97(7), 694-8.

Wiegand, H. "Kish, L.: Survey Sampling. John Wiley & Sons, Inc., New York, London 1965, IX+ 643 S., 31 Abb., 56 Tab., Preis 83 s." (1968): 88-89.

Workineh, S. T., Woldeselassie, H. G., Temesgen, F., Taddese, A., Negussie, T., Kiflu, W., & Derbew, M. (2022). Outcomes of tubularized incised plate urethroplasty (TIPU) for hypospadias at Tikur Anbesa specialized and Menelik II referral hospitals: one-year prospective cohort study. Urology, 168, 189-194.