Comparing Outcomes of Tubularized Incised Plate Urethroplasty in Hypospadias with or without De-epithelialized Dorsal Preputial Dartos Flap as an Intervening Layer- A Pilot Randomized Controlled Trial

Hypospadiasis one of the most common genitourinary birth defects, occurring in around 1 in300 male births. Surgery is the sole treatment option for hypospadias. The mostcommon and baffling problem that occurs after hypospadias repair is theurethrocutaneous fistula (UCF), and its treatment is very challenging. Hence tolessen the incidence of this complication various techniques using vascularisedsoft tissue flaps in between neourethra and skin as an intervening layer arebeing practiced. Although various advantages and disadvantages of theintervening layer have been reported, definitive evidence to establish itssuperiority in reducing post-hypospadias repair complications remains lacking.To address this, we designed a Pilot Randomized Controlled Trial to evaluateand compare the surgical and cosmetic outcomes of Tubularized Incised Plate (TIP) urethroplasty in hypospadias with orwithout de-epithelialized dorsal preputial dartos flap as an intervening layer.The objectives of the study are to compare the combined incidence ofpostoperative complications i.e., urethrocutaneous fistula and glans dehiscenceand to compare the intra operative outcomes, post operative outcomes along withcosmetic appearance using Hypospadias Objective Penile Evaluation (HOPE) score inTubularized Incised Plate urethroplasty with or without the use ofde-epithelialized dorsal preputial dartos flap as an intervening layer at 6months follow-up after surgery.