A comparative study to evaluate the effect of double dartos flaps in primary hypospadias repair: no fistula anymore.
OBJECTIVE
The aim of this study was to compare the complication rates of the single flap and double flaps versus flapless procedure in the tubularized incised plate urethroplasty.


METHODS
One hundred and seventy-two patients with any type of hypospadias underwent surgical repair by tubularized incised plate (TIP) urethroplasty between April 2002 and July 2009 in the two pediatric surgical units. Group 1 (17 patients) underwent hypospadias repair that used the standard TIP urethroplasty. Group 2 (23 patients) had a single dartos flap covering. Group 3 (132 patients) had double dartos flaps covering. Surgeries were performed by one of three surgeons.


RESULTS
In group 3, urethrocutaneous fistula was detected in 1 (0.7%) patient, whereas there were 5 (29.4%) and 6 (26%) fistulas in groups 1 and 2, respectively. Penile torsion was noted in 10 (43.5%) and 5 (3.8%) patients in group 2 and 3, respectively. Four of the patients of group 3 had wound dehiscence (3%). Meatal stenosis was seen in 1 (5.8%), 1 (4.3%) and 6 (4.5%) patients in groups 1, 2 and 3, respectively.


CONCLUSIONS
The additional covering of the neourethra with a second layer dartos flap is an improvement in the TIP urethroplasty, in terms of fistula formation avoidance.
Yiğiter
Murat
M
Faculty of Medicine, Department of Pediatric Surgery, Ataturk University, 25240, Erzurum, Turkey. dryigiter@gmail.com
Yildiz
Abdullah
A
Oral
Akgün
A
Salman
Ahmet Bedii
AB
D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000009:adverse effects*; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000379:methods
J Urol. 1994 Oct;152(4):1229-31
8072110
Int Urol Nephrol. 2008;40(3):573-6
18327654
J Pediatr Surg. 2003 Aug;38(8):1157-61
12891485
J Pediatr Urol. 2010 Aug;6(4):403-7
19857999
Urology. 2002 Jul;60(1):157-62
12100946
BJU Int. 2006 Jan;97(1):166-8
16336350
BJU Int. 2004 Nov;94(7):1102-4
15541136
Urol Int. 2007;78(3):241-4
17406134
J Urol. 1996 Aug;156(2 Pt 2):839-41
8683797
Urology. 2008 Aug;72(2):305-8
18502484
J Urol. 2000 Aug;164(2):489-91
10893631
BJU Int. 2002 Jan;89(1):94-7
11849170
Urol Int. 2009;83(3):354-8
19829040
J Urol. 1999 Sep;162(3 Pt 2):1159-61
10458455
Urol Clin North Am. 2002 May;29(2):285-90, v
12371220
Eur Urol. 2006 Jul;50(1):53-7
16707207
J Urol. 2007 Feb;177(2):698-702
17222659
BJU Int. 2004 May;93(7):1057-61
15142164
BJU Int. 1999 Oct;84(6):683-8
10510116
J Urol. 1994 Feb;151(2):464-5
8283561
BJU Int. 2002 Jul;90(1):88-91
12081777
Int Urol Nephrol. 2008;40(3):569-72
18320341
BJU Int. 2000 Apr;85(6):725-7
10759674
Int Urol Nephrol. 2002;33(1):113-6
12090315
Eur Urol. 2005 Jun;47(6):879-84; discussion 884
15925087
BJU Int. 2005 Mar;95(4):683-93
15705110
Urology. 2005 Nov;66(5):1095-8
16286134
Urology. 2005 Dec;66(6):1305-6
16360463
Int J Urol. 2005 Mar;12(3):280-3
15828956
Urol Int. 2008;81(2):215-7
18758223
J Pediatr Surg. 1998 Dec;33(12):1788-9
9869051
Eur J Pediatr Surg. 2005 Dec;15(6):420-4
16418960