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Charu Tiwari

All India Institute of Medical Sciences, India

Title: Tubularized incised plate urethroplasty and grafted tubularized incised plate urethroplasty

Biography

Biography: Charu Tiwari

Abstract

Abstract

Background: There are around 300 methods for surgical correction of the hypospadias. Amongst these, both Classic Tubularized Incised Plate Urethroplasty (C-TIP) and Grafted Tubularized Incised Plate Urethroplasty (G-TIP) are well known techniques of hypospadias repair. The present study aims to systematically compare the reported outcomes of TIP and G-TIP in children undergoing primary hypospadias repair.

Materials and Methods: We conducted this systematic review and meta-analysis to compare the reported outcomes of TIP and Grafted TIP in children undergoing primary hypospadias repair. This study was conducted in accordance with PRISMA guidelines. PICO was decided. Electronic searches were done in different databases with search term Hypospadias, Snodgrass urethroplasty, TIP, Grafted TIP, DIGU, Snodgraft, Dorsal inlay graft using Boolean Search strategy. UCF, meatal stenosis, glans dehiscence, total complications were outcomes for analysis. Only RCTs were included for final analysis. The search yielded 2571 records, 9 RCTs were identified for final analysis as per inclusion criteria.

Results: There were 265 patients in TIP Group and 265 in G-TIP group. Outcomes like UCF, glans dehiscence, stricture were comparable in both groups. Incidence of metal stenosis is found to be less in grafted group RR 0.29 CI 0.12-0.74.

Conclusion: There is good evidence to say that there is reduced incidence metal stenosis in G-TIP group. Our meta-analysis also reveals that required operative time for TIP is less as compare to G-TIP. As other outcomes like UCF, glans dehiscence, HOSE score, maximum flow rate, success rates are concerned there is no difference in both groups. Trial Sequential Analysis (TSA) has corroborated our meta-analysis finding of meatal stenosis. Further randomized studies are required to reach desired information size for outcome UCF.