Tubularized Incised Plate (TIP) Repair Improves Outcome of Hypospadias Repair

Aim of the study: To analyze if a change of surgical method affects the complication rate in hypospadias surgery. Methods: Over a period of six years, the Mathieu procedure was replaced by the Tubularized Incised Plate (TIP) repair as the most favored method of grade 1-2 hypospadias repair at our clinic. All operated boys were prospectively registered during those years. Two three-year-periods were outlined with equal number of patients: 2010- 2012 and 2013-2015, but with the preferred method of repair reversed. The end point was any complication calling for a reoperation. Main results: In the first period 69 boys were operated whereof 50 Mathieu and 19 TIP. 35 (51%) boys required a reoperation. In the second period 73 boys were operated whereof 19 Mathieu and 54 TIP. 15 (21%) required a reoperation, P < 0.01. Research limitations: The study is prospective but the technique preferred was the choice of the surgeon. Follow up will be continued due to acknowledged accumulation of complications over time. Conclusion: Method seems to matter. Advantage TIP. We are not aware of any other prospective study following a shift in paradigm and at the same time comparing these two procedures for hypospadias repair.