The Efficacy of the TAIPEI (TAping Inbetween PEnile Incisions) Technique for Correcting Penile Curvature in Stage Flap Repair.

Abstract

Objective: To examine the effectiveness of TAping Inbetween PEnile Incisions(TAIPEI) for correcting penile curvature and staged urethral reconstruction with two different flap techniques and report the follow-up data.

Methods: Our prospective cohort included patients with primary hypospadias who underwent two types of staged flap repairs involving urethral plate transection and TAIPEI technique. Curvature angles were objectively measured with standardized erection test at different stage. Reported outcomes include surgical complications and recurrent/persistent curvature.

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 (-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.

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.