https://doi.org/10.4081/aiua.2022.2.206

Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study

Vol. 94 No. 2 (2022)
Submitted: April 1, 2022
Accepted: April 23, 2022
Published: June 30, 2022
Hypospadias; Dartos Fascia; Tunica Vaginalis; Tubularized Incised Plate.
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Authors

Faisal Ahmed
fmaaa2006@yahoo.com
https://orcid.org/0000-0001-7188-2715
Urology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.
Hossein-Ali Nikbakht
Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran, Islamic Republic of.
Khalil Al-Naggar
Urology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.
Saleh Al-Wageeh
Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.
Qasem Alyhari
Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.
Saif Ghabisha
Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.
Ebrahim Al-Shami
https://orcid.org/0000-0002-4513-9562
Urology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.
Menawar Dajenah
Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.
Waleed Aljbri
Department of Urology, School of Medicine, 21 September University, Sana'a, Yemen.
Fawaz Mohammed
Department of Orthopedy, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.
Abdu Al-Hajri
Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.

Background: In the tubularized incised plate (TIP) procedure, flap interposition between the skin and neourethra is highly recommended to decrease the postoperative fistula rate. However, there is no consensus regarding the ideal flap for this procedure. This study aimed to report our experiences in the one-stage TIP hypospadias surgery utilizing dartos flap (DF) (penile skin subcutaneous tissue) and tunica vaginalis flap (TVF) (parietal layer of the testis) as a tissue coverage of neourethra. Methods: In a retrospective study from Sep 2018 to May 2021, 16 cases of hypospadias with different types, ranging from midpenile to penoscrotal types, were managed with TIP urethroplasty using DF or TVF as a tissue coverage of neourethra were enrolled. The demographic characteristics of the participants, type of hypospadias, outcome, and complications were analyzed and compared. Results: We used TVF and DF as soft tissue coverage in 11 (68.8%) and 5 (31.3%) patients, respectively. The mean age was 56.38 ± 47.83 months. Mid-penile, proximal, and penoscrotal hypospadias were presented in 3 (18.8%), 8 (50.0%), and 5(31.2%) patients, respectively. The total success rate was 14 (87.5%), while 2 (12.5%) patients developed a urethrocutaneous fistula, which required delayed closure later. In comparison between TVF and DF groups: the TVF was applied in all patients with moderate and severe chordee and all patients with penoscrotal hypospadias, and six patients with proximal hypospadias, while only three patients with mild chordee and two patients with proximal hypospadias used the DF and showed statistical significance between groups (p < 0.001 and 0.012) respectively. The success rate was 90.9% vs. 80.0% in TVF and DF groups, respectively, with no statistical significance between groups (p = 1.000). Conclusions: In the primary TIP repair, the TVF is a practical option as a DF for the interposition cover of a neourethra, especially in penoscrotal and proximal hypospadias with severe chordee.

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How to Cite

Ahmed, F. ., Nikbakht, H.-A. ., Al-Naggar, K. ., Al-Wageeh, S. ., Alyhari, Q. ., Ghabisha, S. ., Al-Shami, E. ., Dajenah, M. ., Aljbri, W. ., Mohammed, F. ., & Al-Hajri, A. . (2022). Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study. Archivio Italiano Di Urologia E Andrologia, 94(2), 206–210. https://doi.org/10.4081/aiua.2022.2.206

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