ABSTRACT
Purpose: To evaluate the importance of using a double-layer vascularized dartos flap for preventing fistula in Snodgrass hypospadias repair.
Patients and Methods: This study was carried out in the departments of plastic surgery and urology at Al-Azhar University hospitals. The study included 40 patients with primary hypospadias, aged 2 to 22 years (mean age 8.6), and operated from September 2008 to August 2010. Of the 40 patients, 32 had distal hypospadias and 8 had mid-shaft hypospadias. The standard technique of tubularized incised plate (TIP) urethroplasty (Snodgrass procedure) was done with additional double-layer dartos fascia flap coverage. The mean follow-up period was 4.5 months (range 3 to 12 months).
Results: Successful repair of the 40 cases was achieved. Urine flow results were excellent with a normal-looking, slit-like meatus. Two patients (5%) had meatal stenosis at the early postoperative period, which was corrected by urethral dilatation of the external meatus at an interval of up to 2 months, whereas urethrocutaneous fistula developed in 1 patient (2.5%).
Conclusion: A urethral covering dartos flap transposed ventrally with Snodgrass procedure showed a reduced incidence of fistula complication in our hands after hypospadias repair.
KEYWORDS: Hypospadias; Snodgrass procedure; Double-layer vascularized dartos flap
CORRESPONDENCE: Salah Elwagdy, MD, Department of Uro-radiology, Azhar University, Cairo, Egypt (salah_elwagdy@yahoo.com).
CITATION: UroToday Int J. 2011 Dec;4(6):art 69. http://dx.doi.org/10.3834/uij.1944-5784.2011.12.02
