Muhammad Tariq Latif, Naeem Liaqat, Ijaz Ahmad, Sajid Hameed Dar.
Urethral Plate Augmentation using Pedicle Flap of Penile Skin—a modification of TIP repair.
Pak J Med Health Sci Jan ;8(2):334-7.

Aim: we devised a lateral pedical penile skin flap to be inserted into the raw area between the two halves of the incised urethral plate. Methods:: Patients having distal penile hypospadias along with shallow navicular fossa were included in our study. The age range was 2 to 10 years. Patients were admitted through OPD. In surgery the flap was marked on penile skin and flap was raised with its blood supply. After incising the urethral plate the pedical was transposed to the raw area between two halves of urethral plate through a surgically created tunnel beneath adjacent half of urethral plat and was stitched in situ. The rest of repair was completed according to the standard TIP repair protocols. Results: Twenty patients were included in this study. Two of them ended up in partial disruption of repair due to infection. One of them had meatal stenosis which responded well with dilatation. The rest of the patients had excellent results. Discussion: The insertion of this vascularized flap resulted in coverage of the raw area between the two halves of incised urethral plate resulting in excellent cosmetic and functional results. This procedure is especially suitable for the patients with shallow navicular fossa. Conclusion: Lateral pedical flap insertion is a good modification of TIP urethroplasty especially in patients having shallow navicular fossa. It gives good cosmetic results with less post-operative complications.

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