Comparative Outcomes of Urethral Mobilization Versus Tubularized Incised Plate Urethroplasty in the Surgical Management of Distal Hypospadias

Rakesh Kumar Tripathi, Rajesh Kumar Maurya, Vishal Tyagi, Pavani Vatsal

Abstract: Introduction: Hypospadias is a prevalent congenital anomaly in male newborns, characterized by an ectopic urethral meatus, chordee, and abnormal prepuce. Surgical intervention remains the mainstay of treatment, aiming to achieve functional and aesthetic normalization. Among various techniques, Urethral Mobilization (UM) and Tubularized Incised Plate (TIP) urethroplasty are widely utilized for distal hypospadias. Materials and Methods: This prospective comparative study was conducted from January 2019 to October 2021 at GSVM Medical College, Kanpur. Fifty patients with distal hypospadias were randomized into two groups: 25 underwent UM and 25 underwent TIP. Ethical approval was obtained and informed consent secured. Demographic data, operative time, postoperative outcomes, and complications were recorded and analyzed statistically. Results: The UM group demonstrated significantly reduced operative time (mean 57.28 ? 5.25 mins vs.79.44 ? 6.49 mins), earlier catheter removal (mean 3.56 ? 0.82 days vs.5.44 ? 0.86 days), and shorter hospital stay (mean 5.64 ? 0.90 days vs.7.52 ? 1.00 days) compared to TIP. Early complications such as edema and skin necrosis were more frequent in TIP. Late complications like fistula and meatal stenosis were significantly higher in the TIP group. Discussion: UM proves to be a time - efficient and safer alternative to TIP for distal hypospadias with fewer complications and shorter hospitalization. However, surgical decision - making should remain individualized.

Keywords: hypospadias, urethral mobilization, tubularized incised plate, pediatric urology, surgical outcomes