Cosmotic Outcome of Distal Penile Hypospidias Repair Using Stitch by Stitch Glanuloplasty Versus TIP

TIP An 8F straight sound is passed into the hypospadiac meatus to assess skin coverage over the urethra., a circumscribing incision is made 2 mm proximal to the meatus, a U-shaped incision is extended proximally to healthy skin The key step in the operation is a midline relaxing incision made from within the meatus to the distal extent of the plate. This incision extends through the epithelial surface of the plate deeply into underlying connective tissues down to the corpora cavernosaNext, a 6F stent is passed into the bladder for postoperative urinary diversion. Then the urethral plate is tubularized. , stitches are ever taken further distally to ensure the neomeatus has a generous oval openingticular closures. .

SBS in brief Operative technique :starts with penile degloving, preparation of the flap (Site of hypospadic meatus is determined after degloving). Creation of a narrow strip of the urethral plate with wide glanular wings is done using bilateral incisions which are extended to the tip of the glans. The width of the urethral plate is about 3 mm then we suture the flap to the narrow urethral plate in two layers in continuous manner using vicryl 6/0 over a suitable plastic catheter. Triangular (Vshape) area of the distal part of the flap is excised a the midline. After this we anastomose the flap to thetip of the glans. The glans appears opened in the midline as inverted V shape. Closure of the glans is finished in the midline using three mattress interrupted sutures with another three simple stitches are used in between