Outcome Analysis of Tubularized Incised Plate Urethroplasty & Urethral Advancement with Glanuloplasty for Distal Hypospadias in Pediatric Patients of a Tertiary Care Center in Nagpur: A Prospective Open-label Randomized trial.

Hypospadias a common congenital anomaly affecting the male genitourinary system. It is characterized by the abnormal placement of the urethral meatus on the ventral surface of the penis . It occurs in approximately 1 in 250 live male births worldwide, with potentially higher prevalence rates in certain populations, including India (1). This anomaly not only affects physical appearance but also has implications for urinary function and psychological well-being.

Hypospadias is categorised according to the location of urethral meatus in various subcategories of which distal hypospadias is more common position of meatus. There are more than 200 reconstructive procedures described for hypospadias repair with their pros and cons. However, over the last thirty years, the tabularised incised plate urethroplasty (TIPU) described by Snodgrass has gain a popularity and is one of the most commonly performed procedure now a days.  The procedure  creates a neourethra by longitudinally incising and tabularising the urethral plate.(2) The problems with TIPU are comparatively high rates of stricture and fistula following surgery.(3)  Urethral advancement with Glanuloplasty (UAG) is another surgical technique in which the native urethral meatus along with  the bulbous and pendulous segments urethra is advanced to the tip of the glans penis.(4) First described by Beck, the procedure has undergone many modifications over the years.(5) The advantages of this procedure are less risk of post-operative fistula and stricture formation.However, there is only one study which compares the outcome following these procedures.(6)

In order to fill the gap in the literature, this prospective randomized trial is planned with the following aim and objectives