[Tunica vaginalis of testis and spermatic fascia: a good alternative for the repair of urethral fistula resulting from hypospadias operation].

OBJECTIVE: To evaluate the methods of repairing urethral fistula resulting from hypospadias operation. METHODS: We analyzed the clinical data of 46 cases of surgical repair of urethral fistula resulting from hypospadias operation. The patients ranged in age from 3 to 26 (mean 11.7) years. There were 52 fistulas in all, with the diameters of less than 5 mm, of which 25 were in the midshaft of the penis, 12 in the penoscrotum, and 9 in the scrotum. Of the 46 cases, 20 were repaired by continuous knock suture and 26 by tunica vaginalis of testis and spermatic fascia. RESULTS: The one-stage success rate of continuous knock suture repair was 55% (11/20) and that of the combined use of continuous knock suture with tunica vaginalis of testis and spermatic fascia repair was 84.6% (22/26). CONCLUSION: Based on continuous knock suture, the additional use of tunica vaginalis of testis and spermatic fascia yields a high success rate in repairing urethral fistula resulting from hypospadias operation.

Lymphoscintigraphic studies of lymphatic drainage from the testes.

Two colloidal radiopharmaceuticals, Au-198 and Tc-99m antimony, were used to evaluate the lymphatic drainage of the testis in experimental animals and humans. One to 24 hours after direct intratesticular injection of Au-198 colloid in dogs and 4-6 hours after injection of Tc-99m antimony colloid in men, distribution within retroperitoneal lymph nodes was demonstrated. Uptake within the para-aortic lymph nodes primarily draining the testis was decreased following proximal ligation of the spermatic vessels in dogs. Testicular lymphoscintigraphy successfully demonstrated an intact spermatic cord lymphatic communication to the para-aortic nodes in five of six patients with chronic lower-extremity lymphedema. When the intact testicle and spermatic cord were transposed to the thigh in a patient with chronic lymphedema of the lower extremity, percutaneous pedal lymphoscintigraphy successfully demonstrated uptake within the para-aortic lymph nodes draining the ipsilateral testis.