Proximal TIP repair is an excellent alternative (described by Warren Snodgrass from Dallas) for the management of primary proximal hypospadias. It has the advantage of being completed in one stage with a low complication rate (13% reported by Snodgrass et al). It can be combined with maneuvers to straighten the penis such us mobilization of the spongiousum/ urethral plate complex as well as ventral corporotomies and single midline dorsal plication. Those patients with severe ventral curvatures and corporeal disproportion may require a two-stage operation as described by Bracka. |