Modified meatal-based tube-flipping technique for distal and mid-shaft hypospadias: clinical outcomes in a large cohort.

Abstract

Introduction: The aim of this work was to assess the functional, cosmetic and complication outcomes of meatal-based tube-flipping urethroplasty in the management of distal and mid-shaft hypospadias.

Methods: This retrospective study included 244 patients presenting with distal or mid-shaft hypospadias, with or without associated chordee, regardless of age. All patients underwent urethral reconstruction using the meatal-based tube-flipping technique. Postoperative evaluation was performed to determine urinary function, cosmetic appearance and the incidence of postoperative complications. Specific outcomes assessed included recurrence of chordee, meatal stenosis and urethrocutaneous fistula formation. Follow-up was conducted in the outpatient clinic with clinical examination and cosmetic assessment by the operating surgeon.

Results: Satisfactory urinary flow and penile appearance were achieved in the majority of patients. No cases of recurrent chordee or meatal stenosis were recorded during follow-up. Urethrocutaneous fistula occurred in 8.6% of patients, representing the primary postoperative complication.

Conclusion: Meatal-based tube-flipping urethroplasty demonstrates favourable functional and cosmetic outcomes in the management of distal and mid-shaft hypospadias. This technique represents a practical modification of established methods, demonstrating reliable outcomes with an acceptable complication profile.