THE GITUP (GLANULOPLASTY AND IN SITU TUBULARIZATION OF THE URETHRAL PLATE) HYPOSPADIAS REPAIR: A SIMPLE TECHNIQUE FOR DISTAL HYPOSPADIAS REPAIRS

• Published in: Pediatrics (Evanston) Vol. 104; no. 3; p. 847
• Main Authors: Chung, Andrew K, Kass, Evan J
• Format: Journal Article
• Language: English
• Published: American Academy of Pediatrics 01-09-1999
• Subjects: Pediatrics
• ISSN: 0031-4005; 1098-4275

Background: In 1995 we initially described the GITUP hypospadias repair which involves tubularization of the urethral plate in order to produce a normal appearing urethral meatus. This technique incorporates elements of the King and Thiersch-Duplay techniques for hypospadias repair. Subsequently, Snodgrass described a similar procedure that required incision of the urethral plate in order to create a neourethra of greater caliber. We have not found this modification necessary in the vast majority of children and herein describe the GITUP hypospadias repair in 308 children without incision of the urethral plate. Methods: The original paper describing the GITUP technique in 1995 reviewed 166 patients. We have since reviewed an additional 142 patients for a total of 308 patients. Follow-up consisted of patient visits at 1 week, 6 week and 1 year intervals. Telephone contact was attempted if one year follow-up was not obtained. If there were no complications at one year, the patient was discharged from follow-up unless further problems occurred. Results: Overall cosmetic results were excellent. Our overall complication rate was 9.4%, and consisted of a urethral fistula (8.4%) and two urethral diverticula (0.6%). There was no evidence of meatal stenosis, urethral stricture, residual chordee, balanitis or hematoma formation. In addition, in comparing the last 142 patients with the first 166, we have noted that our complication rates have dropped from 8% to 1.7% in patients with a distal/coronal hypospadias, and from 20% to 7.7% in patients with a midshaft hypospadias. We believe that this is due to the addition of a third layer of spongy tissue and a subcutaneous transverse island flap in the repair for most patients. Also of note, only 4 of the 29 complications occurred after the first year (13.8%). Thus, it appears that the functional durability of the repair has been lasting. Conclusion: The GITUP hypospadias repair is a simple, reliable and durable technique for distal hypospadias repairs with a low complication rate.