title: Multicentric experience on double dartos flap protection in tubularized incised plate urethroplasty for distal and midpenile hypospadias.
abstract: OBJECTIVE
  We report a multicenter experience using double dartos flap to protect the neourethra in TIP urethroplasty for distal and midpenile hypospadias.
  
  
  METHODS
  A total of 394 patients underwent tubularized incised plate urethroplasty for primary distal and midpenile hypospadias using double dartos flap protection by ten pediatric surgeons and urologists at five different institutions.
  
  
  RESULTS
  Tubularized incised plate urethroplasty protected by a double dartos flap was simple to perform and flaps were easy to obtain. Complications occurred in 23 patients (5.83%): fistulas 1.01% (4 cases), stenosis 0.25% (1 case), mild stenosis 2.53% (10 cases), dehiscence of ventral cutis 0.50% (2 cases) and penile torsion 1.26% (5 cases). All fistulae had a spontaneous resolution.
  
  
  CONCLUSIONS
  Double dartos flap to protect tubularized incised plate urethroplasty is safe with a low complication rate. The neourethra is covered entirely with a double layer of vascularized tissue and the double coverage appears a good choice for preventing urethrocutaneous fistula formation.
authors.affiliation: S. C. di Clinica Chirurgica Pediatrica, Ospedale S. Maria della Misericordia, Università degli Studi di Perugia, 06100 S. Andrea delle Fratte, Perugia, Italy. mirkobertozzi@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Bertozzi
authors.forename: A
authors.initials: A
authors.lastname: Yıldız
authors.forename: B
authors.initials: B
authors.lastname: Kamal
authors.forename: M
authors.initials: M
authors.lastname: Mustafa
authors.forename: M
authors.initials: M
authors.lastname: Prestipino
authors.forename: M
authors.initials: M
authors.lastname: Yiğiter
authors.forename: H
authors.initials: H
authors.lastname: Al-Darawany
authors.forename: A
authors.initials: A
authors.lastname: Oral
authors.forename: N
authors.initials: N
authors.lastname: Nardi
authors.forename: A
authors.initials: A
authors.lastname: Appignani
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000175:diagnosis / Q000601:surgery*; D007223:Infant; D008297:Male; D010413:Penis / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012720:Severity of Illness Index; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*