TIP (Snodgrass) Repair

• The area around the opening and the borders of the urethral plate are marked.
• The skin is released and the curvature is assessed.
• The plate is cut lengthwise along the midline and deepened — this is the "incised" step in the technique's name, and it's what allows a narrow plate to be turned into a tube.
• The edges of the plate are brought together at the midline and turned into a tube (tubularized).
• A protective layer of dartos tissue is laid over the new channel.
• The glans is closed over the channel, and the skin is reshaped.

Because the channel is built from the patient's own plate, no additional tissue needs to be harvested. The opening ends up as a natural-looking vertical slit. The technique can be applied across a wide range, from distal to proximal cases.

• Healing of the midline incision can cause some worry, but this area covers itself with new tissue on its own and doesn't cause a clinical problem.

If the plate is too narrow, thin, or scarred, TIP alone isn't enough. In that case, the plate is widened with a small graft (Snodgraft), or the approach switches to a staged repair.