Introduction
chordee, hypospadias, fibrosis, stenosis
FIBROSIS, STENOSIS
In 1994, Snodgrass reported the use of tubularized incised plate urethroplasty (TIPU) with a urethral plate incision that not only widened the plate but also provided a slit-like vertical neourethral meatus, the incised plate healing is still a matter of debate, some authors think that there is complete re-epithelization while others believe that there is granulation tissue formation that later is healed by gradual fibrosis that can lead to several unfavorable outcomes, including meatal and neourethral stenosis, which require regular urethral dilatation [Several factors affecting the outcome of hypospadias repair such as meatal location, age at time of repair, presence of chordee, surgical technique, surgeon experience and urethral plate, the urethral plate characteristics that affect the surgical outcome of TIPU has been studied in many series [Many studies have postulated that the augmentation of the narrow urethral plate with a free inlay inner preputial graft (Snodgraft) or Onlay preputial flap provides superior outcomes than conventional TIPU [Hence, we conducted our study comparing the outcomes among inlay grafted incised plate, onlay Island Flap and our previous records of TIPU in patients with a narrow urethral plate, aiming to determine which method of repair provides a good outcome.
