Outcome of Using Double Dartos Flaps in Tubularized Incised Plate Repair of Primary Distal Hypospadias

Document Type : Original Article

Authors

1 Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

2 Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

3 Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

Abstract

Background: using a second layer for neourethral coverage is strongly recommended in Tubularized Incised Plate (TIP) hypospadias repair. Double Dartos flaps (DDF) technique has been reported to decrease the postoperative complications, especially urethrocutaneous fistula (UCF). Aim: to evaluate the effect of neourethral coverage with DDF – compared to single Dartos flap (SDF)- on postoperative rate of meatal stenosis and other complications of TIP repair for primary distal hypospadias.Patients and methods: A total of 52 patients with primary distal hypospadias were randomized into two groups according to the method of neourethral coverage: twenty four patients in group A (mean age 38±28 months) and 28 in group B (mean age 36±29 months). The classical technique of SDF was used in group A and DDF technique was applied for group B. Results:after a minimum follow up for 6 months (mean 15±11months for group A, 17±8 months for group B), group B showed better outcome and lower rates of UCF (3.6% compared to 12.5% in group A). The application of DDF in group B did not increase the rate of meatal stenosis (3.6% compared to 8.3% in group A), although not statistically significant. Additionally, group B did not show any cases of penile torsion compared to 2 cases in group A. Conclusion: the use of DDF did not significantly affect the rate of meatal stenosis after TIP repair. However, it appears to reduce other postoperative complications such as UCF and penile torsion.

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