TUNICA VAGINALIS FLAP (TVF) AS AN ALTERNATIVE TO DARTOS FLAP IN PRIMARY HYPOSPADIAS REPAIR- OUR EXPERIENCE.

Corresponding Author:
Dr. Nagendra Singh,
Flat No. 6, Block 1,
BMC Campus, Sagar-470001, Madhya Pradesh.
E-mail: drnagendra.804@gmail.com

ABSTRACT

Background

Hypospadias is one of the common anomalies in boys. No single technique is considered perfect for hypospadias repair, it lead to many techniques described for its repair. Post-operative fistula formation is the commonest complication of hypospadias surgery and this complication usually requires further surgeries. To avoid this complication, various soft tissue interposition grafts are introduced. Tunica vaginalis flap is one of them. Tunica vaginalis has extra-penile vascularity, hence helping in healing of suture line of neourethra. We plan a comparative prospective study of tunica vaginalis flap and Dartos flap over two years, which show good results with TVF with significant decrease of urethrocutaneous fistula rate. TVF is a viable option as compared to Dartos flap in primary repair of hypospadias.

MATERIALS AND METHODS

Study was conducted for 2 years in total 48 patients. 24 patients (Group A), who were candidates for a primary single-stage urethroplasty were prospectively chosen for TVF repair as soft tissue cover. Patients of equal number, who were comparable in age and type of hypospadias were taken as controls (Group B) operated with using Dartos flap as soft tissue cover.

Results

All patients in Group A were repaired successfully. Only one patient developed superficial wound dehiscence and treated conservatively. No fistula was noted in any of the patients in this group. In Group B Fistula developed in 3 patients, which required delayed closure later on. Three patients developed localised superficial necrosis of the ventral penile skin, which was managed conservatively.

Conclusion

Tunica vaginalis flap (TVF) is a viable option as compared to Dartos flap in primary repair of hypospadias.

Keywords

Hypospadias, fistula, tunica vaginalis flap.