Use of Dorsal Dartos Pedicled Flap Single or Double Layered in Preventing the Fistula Rate Following Tubularized Incised Plate Repair in Distal Hypospadias: A Prospective Randomized Study.

ABSTRACT

Introduction: Hypospadias is defined as an anomaly involving the ventral aspect of the penis with variable location of meatus from the tip with or without chordae. Objective: To study the role of dorsal dartos pedicled flap for reducing the fistula rate in tubularized incised plate (TIP) repair for distal hypospadias. Methods: Between November 2012 and August 2015, a total of 65 patients with distal penile hypospadias age between 1 and 18 years were included in this study. Patients were divided into 2 groups. Group (A) had 35 patients in which a single layer of dartos flap was used to cover the neourethra during TIP repair while in Group (B) which had 30 patients, the dartos flap was split into two halves and used to cover the neourethra in a double breasting fashion. Patients were followed regularly up to 6 months postoperatively. Results: The success rate shows no statistically significant difference between Group A 35 (94.29%) and B 30 (96.67%) P > 0.05. All successful patients had a satisfactory cosmetic result with a conical glans and vertical slit-like meatus. These results were compared with our 30 cases done previously without using a dartos flap which had a success rate of only 80%. Conclusion: Dartos pedicled coverage of TIP repair offers a significant reduction in fistula rate after TIP in distal hypospadias even though single or double layers of dartos coverage had no significant difference in results.