title: Single vs. double dartos interposition flaps in preventing urethrocutaneous fistula after tubularized incised plate urethroplasty in primary distal hypospadias: a prospective randomized study.
abstract: BACKGROUND
  This prospective study was designed to compare symmetrical overlapping double flaps with a single dartos flap in regard to fistula formation as an adjunct to tubularized incised plate urethroplasty (TIPU).
  
  
  METHODS
  77 consecutive children with primary coronal or subcoronal hypospadias were randomized into 2 groups. A single layer dartos flap was used to cover the anastomotic site in the first group (37 patients). A wider dorsal dartos flap bisectioned in the midline was utilized in the second group of 40 patients. The complication rates were compared.
  
  
  RESULTS
  There was no difference between the 2 groups in terms of age, and meatal location. Postoperative median follow-up was 34 months. Urethrocutaneous fistula occurred in 3 patients (8.1%) of the monolayer group. No fistula developed in the second group with double flaps.
  
  
  CONCLUSIONS
  The current study proposes that the use of double dorsal flaps, although statistically not significant, better prevents fistula formation compared to monolayer dartos flaps following TIPU operation.
authors.affiliation: Department of Urology, Duzce University School of Medicine, Duzce, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Erol
authors.forename: Ali
authors.initials: A
authors.lastname: Kayikci
authors.forename: Omur
authors.initials: O
authors.lastname: Memik
authors.forename: Kamil
authors.initials: K
authors.lastname: Cam
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Akman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D017577:Cutaneous Fistula / Q000517:prevention & control*; D006801:Humans; D007021:Hypospadias / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery*; D014522:Urethral Diseases / Q000517:prevention & control*; D014548:Urinary Fistula / Q000517:prevention & control*; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D055815:Young Adult