الفهرس 
ContentsOnly 14 pages are availabe for public view
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Abstract
Hypospadias is the second most common birth defect in males, occurring in approximately 0.8% of boys. Rate doubled from 1 out of 300 boys to 1 out of 125 boys during the last few decades. Tubularized incised plate urethroplasty repair has become the most popular technique for repairing distal hypospadias at many institutions during the last 2 decades. Although this technique is easily applicable with good cosmetic results, several complications, including meatal and/or neourethral stenosis, have been reported. Unilateral Koyanagi’s technique is a modification by using a unilateral instead of a bilateral parameatal foreskin flap with preservation of the pedicle as well as the lateral blood supply. This technique showed encouraging results on distal hypospadias, especially in cases with narrow urethral plate. This current thesis was a prospective randomized comparative single blinded study performed from May 2018 to May 2020. It included 60 patients, divided randomly into 2 groups; where Tubularized Incised Plate repair performed in group A and unilateral Koyanagi in group B. Both groups were compared regarding operative time, postoperative complications, and voiding pattern. Moreover, the relation between the preoperative urethral plate width and the postoperative outcome was studied in both groups. Mean operative time was 92.7 minutes in group A versus 106.4 minutes in group B (P < 0.001). Success rate was 83.4% after TIP versus 80% after unilateral Koyanagi (P= 0.74). There were no significant differences between both groups regarding all types of complications. However, meatal stenosis was 5 times higher in group A (P= 0.19), whereas urethrocutaneous fistula showed double incidence in group B (P= 0.67). The preoperative width of urethral plate correlate with postoperative caliber of the neourthra and with the postoperative incidence of meatal stenosis in group A, but there were no such correlations in group B. Conclusion: Unilateral Koyanagi’s repair shows a comparable postoperative outcome to Tubularized Incised Plate technique, in spite of being more complicated with longer operative time. Narrow urethral plate had its impact on the postoperative outcome after Tubularized Incised plate but not after unilateral Koyanagi’s repair as we had found that the increased width of augmented tubarized flap in cases operated for unilateral Koyangi have given an advantage for cases with narrow urethral plate which clearly reflected on the claliber of neourethra with remarkable statistically significant evidences.