الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Development of external genitalia occurs via three main pathways: (1) androgen-independent, (2) androgen-dependent, and (3) endocrine/ environmental influence.
The urethra stretches from the bladder to the tip of the glans penis, serving as a passage for urine and semen.
Hypospadias is the second most common congenital anomaly after undescended testis. Due to incomplete closure of the penile structures during embryogenesis
Hypospadias is often classified into anterior: the urethral opening is slightly displaced but still in the glandular or subcoronal region; middle hypospadias: the urethra opens into the ventral surface of the penis; and posterior hypospadias.
The etiology of hypospadias is largely unknown. Some hypospadias are monogenetic in origin, but the vast majority of cases seem to be multifactorial with many genetic and environmental factors playing a role.
Hypospadias is generally defined as the combination of three anatomic anomalies of the penis, which are an abnormal ventral opening of the urethral orifice, ventral curvature of the penis, and abnormal distribution of the foreskin around the glans with a ventrally deficient hooded foreskin
Currently, there are multiple surgical techniques employed worldwide for hypospadias repair. The proper timing of genital reconstruction is age 6 months to 1 year. The initial hypospadias surgical repair may be single or staged, depending on many factors, such as severity of ventral chordee, location of urethral meatus, deficiency of genital tissues and, surgeon preference
Urethroplasty surgery for hypospadias has risks such as meatal stenosis, urethro-cutaneous fistula, and multiple surgeries. These complications may lead to multiple surgeries throughout childhood. This raises the question of why mild forms of hypospadias are treated with urethroplasty when many of these patients will potentially have no complications if left untreated
This was prospective study included randomized thirty patients with crippled hypospadias who were presented to Menoufia University Hospital. Their ages ranged between 6 months and 14 years old.
According to the surgical procedure used, patients of the study ”30 patients” were classified into three groups:
group A: Patients underwent TIP urethroplasty.
group B: Patients underwent Thiersch Duplay urethroplasty.
group C: patients underwent Buccal mucosal graft.
All patients were followed-up in the Outpatient Clinic as follows:
1. In Outpatients Clinic; patients were examined every week during the first month and every two weeks for five months.
2. The items of assessment included were:
Force and caliber of the urinary stream.
Degree of post-operative edema.
Presence of complications.
Evaluation of late results 3-6 months post-operative.
In our study, patients underwent previous operations for correction of hypospadias ranged from one time to three or more times.
In our study; fibrous chordee of various degree were present and corrected before urethroplasty.
The commonly encountered early post-operative complications were urethro-cutaneous fistula, infection, edema, hematuria, while hemorrhage, retention and the complete failure were the rarest early post-operative complications.
The late post-operative complications that commonly encountered were urethro-cutaneous fistula, meatal stenosis, while uretheral stricture and complications of the donor site were the rarest late post-operative complications.