BACKGROUND: In this study, we examine the effectiveness of TAping Inbetween PEnile Incisions(TAIPEI) for correcting penile curvature following transection of urethral plate(UP) in conjunction with two different staged flap techniques and report the follow-up data.
METHODS: Our prospective study included patients with primary hypospadias who underwent two types of staged flap repairs involving UP transection and TAIPEI technique. Curvature angles were objectively measured during artificial erection after degloving, after UP transection, and at stage 2. After second stage repair, curvature was reassessed with natural erection or standardized erection test.
RESULTS: We included 64 eligible patients from June 2020 to December 2021. In the first stage, all patients underwent urethral plate transection for the straightening of penile curvature. Of these, 19 patients received the Transverse Preputial Island Flap, while 45 patients underwent the Byars Flap. The median curvature angle was 55º (IQR 44-74) after degloving, 52º (IQR 41-70) after UP transection, and 0º (IQR -5-0) at the second stage after TAIPEI. There was no significant difference in the success rate of curvature correction after TAIPEI between the two flap groups; both groups achieved nearly or exceeded 95% success.
With a median follow-up of 19.3 (IQR 17.6—24.4) months, 42 patients had eligible data on curvature after stage 2. Almost 80% (32/42) had a straight penis. Overall, 90% (38/42) had penile curvature less than 30 degrees.
In terms of surgical complications, in group 1, the complication rate was 15.8% (3 out of 19 patients), with two patients developing diverticulum and one patient experiencing a coronal fistula. In group 2, the complication rate was 8.9% (4 out of 45 patients), involving two cases of diverticulum, one instance of partial dehiscence, and one fistula. Additionally, these complications necessitated an additional six surgeries to manage the cases without further complications.
CONCLUSIONS: Remodeling penile curvature with the TAIPEI technique is successful using either the staged Byar’s flap or the transverse preputial island flap. Long-term follow-up is warranty to evaluate the long-term outcomes of this approach.
