Hypospadias TIP repair (tubularized urethroplasty with or without incision of the urethra plate)

(A) Proximal hypospadias with a stent in the abnormal urethral meatus. Note the location of the abnormal urethral meatus at the penoscrotal junction. In the initial dissection, a ventral strip of skin (the urethral plate) has been preserved on the penile shaft.
(B) In this case, the urethral plate is adequate in width and, therefore, is reconstructed into a tube over the stent, bringing the new urethral meatus to a normal position at the tip of the glans penis.
(C) If the urethral plate is not wide enough to be reconstructed into an adequate tube, then the plate can be incised with a relaxing incision, and then sewn into an adequate tube. The raw area that is incised will undergo epithelization during the healing process.
(D) The glans penis is reconstructed, and subcutaneous tissue is used to cover the urethra with extra layers to prevent fistula formation.
(E) The extra dorsal skin is trimmed and sewn together to complete the hypospadias repair by primary tubularization with or without incision of the urethral plate.