Surgical repair techniques in hypospadias with unfavorable urethral plate: A systematic review and network meta-analysis.

Summary: Hypospadias is a common birth defect in boys where the urinary opening is not located at the tip of the penis. Repairing this becomes much harder when the surrounding tissue (the urethral plate) is of poor quality. Surgeons have debated which technique works best for these difficult cases: standard tubularization (TIP), using skin flaps, or adding a graft (GTIP). A new review of 20 studies involving nearly 1,500 patients suggests that the GTIP method—combining a graft with the repair—results in the fewest overall complications. While skin flaps also performed well in preventing wound reopening, the GTIP approach appears to be the safest bet for these complex repairs.