High odds for freedom from early complications after tubularized incised-plate urethroplasty in 1-year-old versus 5-year-old boys.

OBJECTIVE: We present two parallel case series on outcome after tubularized incised-plate urethroplasty (TIP repair) for hypospadias in 1-year-old versus 5-year-old boys. PATIENTS AND METHODS: Over a 2-year period two groups (1 year old, n=57 and 5 years old, n=65) of boys were operated in parallel using the TIP repair. Main endpoints were set as incidence of fistula, meatal stenosis and foreskin dehiscence/phimosis. A logistic regression model was used to predict the odds for freedom from either 'any complication' or fistula in 1-year-old boys versus 5-year-old boys. RESULTS: Five-year-old boys had a significantly higher incidence of fistula (26% vs. 7%, P<0.01) and 'any complication' (50% vs. 18%, P<0.001) than the 1-year-old boys. The odds ratio for freedom from 'any complication' and fistula was 4.8:1 (P<0.001) and 4.7:1 (P=0.009), respectively, in favor of the 1-year-old group. Avoiding foreskin reconstruction gave increased odds for freedom of "any complication" (4.2:1, P=0.034), but was an insignificant factor concerning freedom from fistula. CONCLUSION: These data substantiate why boys with hypospadias should be corrected early. Foreskin reconstruction increases postoperative problems but does not increase the rate of postoperative fistulae.