Cosmetic Outcome of Tubularized Incised Plate Depends on The Type of Hypospadias A Case Control Study

Background: Recent studies show Tubularized Incised Plate (TIP) urethroplasty, commonly used for distal hypospadias repair, can be used in proximal hypospadias with a decent success rate. It was contented that the age of the patient and the type of hypospadias when underwent the surgery influences the outcome. One the objectives of hypospadias repair is the cosmetic outcome, which can be evaluated using Hypospadias Objective Penile Evaluation (HOPE) questionnaire. Our objective was to compare the age group and the hypospadias type based on the cosmetic surgical outcome. Methods: In Sanglah General Hospital, Denpasar, 38 patients who had undergone a TIP urethroplasty from January 2012 until December 2015 were evaluated using HOPE questionnaire. Results: The sample were consecutively recruited into two equally-numbered groups based on the HOPE total score. The median of the age of the subjects when they undergone the surgery was 4.8 years (1.89-18.10). The proportion of the over 5 year-old in the cosmetically unsatisfying group (case) was the same as the proportion in the cosmetically satisfying group (control), 52.63%, EOR=1 (p>0.05). The proportion based on the year of surgery were different, but not statistically significant (p>0.05). Based on the type of hypospadias, the proportion of subjects with proximal hypospadias in the case group was more than in the control group, EOR=14.95 (p<0.05). It showed proximal hypospadias a risk factor for cosmetically unsatisfying result post TIP. Conclusions: It should be taken into account that TIP in proximal hypospadias has a greater risk to produce an unsatisfying cosmetic result.