Background: To determine the outcomes of hypospadias repair according to the width of the urethral plate & glanular width. Materials and methods A prospective evaluation of patients operated for hypospadias. The urethral plate width (UPW) & glans width (GW) of the patients were measured preoperatively using standard calipers. The urethral plate width was correlated to the cosmetic outcome (using hypospadias objective penile evaluation [HOPE]) and functional outcome (using the urinary stream) of repair. All patients were managed via the same technique using Snodgrass tubularized incised plate repair (TIP). All intraoperative data were recorded. All patients were followed up for 1 year. Success was deﬁned as slit shaped meatus at the tip of the glans without stenosis, ﬁstula or diverticulum.
Results: All 38 patients were evaluated at 6 months and 1 year follow up. The mean age at surgery was 4.5 ± 2.1 years. We categorized the patients into two groups:- (Group A) had a urethral plate width of less than 8 mm, they were 24 patients (63.15 %). (Group B) had a urethral plate width greater or equal to 8 mm. (group B) had a urethral plate width greater or equal to 8 mm, they are 14 patients (36.8 %) Overall, the mean ± of UPW was 10.92 ± 1.24 mm while the mean ± SD of GW was 9.52 ± 1.56 mm. Success was documented in 36/38 patients (94.7%). The documented complication was Fistula in two patient (5.2 %), glans dehiscensce in three patients (7.9%). Success rate was not statistically different in correlation of UPW and GW (p=0.5). The urinary stream was straight in 32 boys and sprayed in 6. Overall, mean ± SD HOPE score was 39.1 ± 8.83. The only statistically signiﬁcant difference between all patients was a longer operative time in the patients with deficient urethral plate compared to others with adequate urethral plate (p= 0.005). A significant correlation found between the cosmetic outcome of the two groups and HOPE score (p = 0.06).
Conclusions: The pre-incision urethral plate width and glanular width was not correlated with the TIP outcome. A better HOPE score is associated with wide urethral plate.