title: A comparative study to evaluate the effect of double dartos flaps in primary hypospadias repair: no fistula anymore.
abstract: 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.
authors.affiliation: Faculty of Medicine, Department of Pediatric Surgery, Ataturk University, 25240, Erzurum, Turkey. dryigiter@gmail.com
authors.forename: Murat
authors.initials: M
authors.lastname: Yiğiter
authors.forename: Abdullah
authors.initials: A
authors.lastname: Yildiz
authors.forename: Akgün
authors.initials: A
authors.lastname: Oral
authors.forename: Ahmet Bedii
authors.initials: AB
authors.lastname: Salman
mesh_terms: 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
references.citation: J Urol. 1994 Oct;152(4):1229-31
references.pmid: 8072110
references.citation: Int Urol Nephrol. 2008;40(3):573-6
references.pmid: 18327654
references.citation: J Pediatr Surg. 2003 Aug;38(8):1157-61
references.pmid: 12891485
references.citation: J Pediatr Urol. 2010 Aug;6(4):403-7
references.pmid: 19857999
references.citation: Urology. 2002 Jul;60(1):157-62
references.pmid: 12100946
references.citation: BJU Int. 2006 Jan;97(1):166-8
references.pmid: 16336350
references.citation: BJU Int. 2004 Nov;94(7):1102-4
references.pmid: 15541136
references.citation: Urol Int. 2007;78(3):241-4
references.pmid: 17406134
references.citation: J Urol. 1996 Aug;156(2 Pt 2):839-41
references.pmid: 8683797
references.citation: Urology. 2008 Aug;72(2):305-8
references.pmid: 18502484
references.citation: J Urol. 2000 Aug;164(2):489-91
references.pmid: 10893631
references.citation: BJU Int. 2002 Jan;89(1):94-7
references.pmid: 11849170
references.citation: Urol Int. 2009;83(3):354-8
references.pmid: 19829040
references.citation: J Urol. 1999 Sep;162(3 Pt 2):1159-61
references.pmid: 10458455
references.citation: Urol Clin North Am. 2002 May;29(2):285-90, v
references.pmid: 12371220
references.citation: Eur Urol. 2006 Jul;50(1):53-7
references.pmid: 16707207
references.citation: J Urol. 2007 Feb;177(2):698-702
references.pmid: 17222659
references.citation: BJU Int. 2004 May;93(7):1057-61
references.pmid: 15142164
references.citation: BJU Int. 1999 Oct;84(6):683-8
references.pmid: 10510116
references.citation: J Urol. 1994 Feb;151(2):464-5
references.pmid: 8283561
references.citation: BJU Int. 2002 Jul;90(1):88-91
references.pmid: 12081777
references.citation: Int Urol Nephrol. 2008;40(3):569-72
references.pmid: 18320341
references.citation: BJU Int. 2000 Apr;85(6):725-7
references.pmid: 10759674
references.citation: Int Urol Nephrol. 2002;33(1):113-6
references.pmid: 12090315
references.citation: Eur Urol. 2005 Jun;47(6):879-84; discussion 884
references.pmid: 15925087
references.citation: BJU Int. 2005 Mar;95(4):683-93
references.pmid: 15705110
references.citation: Urology. 2005 Nov;66(5):1095-8
references.pmid: 16286134
references.citation: Urology. 2005 Dec;66(6):1305-6
references.pmid: 16360463
references.citation: Int J Urol. 2005 Mar;12(3):280-3
references.pmid: 15828956
references.citation: Urol Int. 2008;81(2):215-7
references.pmid: 18758223
references.citation: J Pediatr Surg. 1998 Dec;33(12):1788-9
references.pmid: 9869051
references.citation: Eur J Pediatr Surg. 2005 Dec;15(6):420-4
references.pmid: 16418960