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Background: Since invention of tubularized incised plate urethroplasty, many modifications have been proposed searching for excellence and perfection. Distal extension of the midline urethral plate incision beyond glanular demarcation as a modification of the standard technique was critically evaluated and compared with the original technique in a prospective study and investigating predictors of success. Methods: In this prospective study, patients with primary distal hypospadias presented for repair between June 2015 and January 2019 were randomized to undergo either extended midline incision of the urethral plate (e-TIP) or standard technique (s-TIP). Cosmetic outcome was evaluated postoperatively using Hypospadias Objective Penile Evaluation (HOPE) score and measuring ventral glans closure length (VGCL) and meatal length (ML). The functional outcome was assessed by uroflowmetry and postvoid residual urine. Qmax and Qave values were plotted against voided volume on a nomogram of age matched children. The impact of preoperative parameters on the outcomes were assessed with linear regression analysis. Results: Out of 110 randomized, 94 cases were available for analysis, 46 in e-TIP group and 48 cases in s-TIP group with comparable preoperative demographics. Postoperatively, higher median (range) of HOPE score in e-TIP was 57(45–60) versus 55(44–60) in s-TIP (p |
