title: Vascularized Dartos Flap in Conjunction with Tubularized Incised Plate Urethroplasty: Single versus Double Flaps for Management of Distal Hypospadias.
abstract: OBJECTIVE
  To compare the results of Snodgrass repair with single versus double vascularized dartos pedicle flap for neouretheral coverage.
  
  
  METHODS
  Fifty-eight pediatric patients with mean age 41.5 ± 21 months (range 9-96 months) underwent primary hypospadias repair, 39 uncircumcised and 19 circumcised, classified into 2 groups according to coverage of the neourethra. Single layer coverage (Group I) was performed in 28 (48.3%) while double layers coverage (Group II) was done in 30 (51.7%) cases.
  
  
  RESULTS
  After mean follow-up 8.6 ± 5.4 months (range 3-24 months), good cosmetic results with vertical slit like meatus at the tip of conical shaped glans were obtained in 53 cases (91.4%). Totally 5 cases occurred postoperative complications, of which 4 cases in Group I [2 (7.1%) with urethrocutaneous fistula, 1 (3.6%) with meatal stenosis and 1 (3.6%) with skin necrosis], 1 case in Group II [glanular dehiscence (3.3%)]. No fistula was observed in Group II.
  
  
  CONCLUSIONS
  The Snodgrass tubularized incised-plate repair in conjunction with double layer coverage of the neourethra could be considered the procedure of choice for distal hypospadias with low complications rate especially urethrocutaneous fistula.
authors.affiliation: Urology Department, Benha Faculty of Medicine, Benha, Egypt.
authors.forename: Ayman
authors.initials: A
authors.lastname: Safwat
authors.affiliation: Urology Department, Benha Faculty of Medicine, Benha, Egypt ; Urology Department, Al-Adwani General Hospital, Taif, Saudi Arabia.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Al-Adl
authors.affiliation: Urology Department, Benha Faculty of Medicine, Benha, Egypt.
authors.forename: Tarek
authors.initials: T
authors.lastname: El-Karamany
keywords: Dartos flap; Fistula; Hypospadias; Tubularized incised-plate; Urethroplasty