Warren Snodgrass and Nicol Bush have been searching for the best operation to repair severe hypospadias in boys with chordee. For a time they did TIP repair after extensive dissection of the urethral plate. Most of these operations were a success, but a few patients developed strictures needing reoperation using grafts from the mouth. Some additional patients can also develop recurrent curvature of the penis. Consequently, they reported to other surgeons in this article that they no longer recommend this hypospadias repair, but instead Snodgrass and Bush now correct severe hypospadias with chordee using a foreskin graft.
Urethral strictures following urethral plate and proximal urethral elevation during proximal TIP hypospadias repair.