This video demonstrates the TAIPEI (TAping Inbetween PEnile Incisions) procedure for managing proximal hypospadias with penile curvature greater than 30º. The video details how and when to perform a standardized artificial erection test without a tourniquet.
Following the erection test, the first stage of repair starts with degloving the penile skin, followed by another erection test. For curvatures over 30º, the urethral plate is transected. A mixture of lidocaine and epinephrine is injected into the dissection plane, and the urethral plate is elevated and transected at the coronal level distally. Another erection test is performed right after transecting the urethral plate, and the curvature is measured and recorded. The transected urethral plate is then fixed onto the corporal bodies in a proximal position without tension. The next step involves glans dissection and preparing Byar’s flap.
Post-operatively, taping begins at week three and continues until the second stage, typically for at least six months. A family survey revealed that 90% of respondents rated the taping process as moderate to very simple after an initial adjustment period.
The second stage is performed at least six months after the first, confirming penile straightness with an erection test. The neourethra is tubularized and closed in two layers using interrupted subepithelial 7-0 PDS sutures, then covered with de-epithelialized prepuce skin. A 6 Fr catheter and elastic gauze bandage are left in place for 10-14 days.
This video aims to enhance understanding and execution of the TAIPEI procedure, providing valuable guidance for surgeons managing proximal hypospadias with severe penile curvature.
