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S14-15
(P)
IS TUNICA VAGINALIS FLAP BETTER THAN DARTOS FLAP AS SECOND LAYER FOR
TUBULARIZED INCISED PLATE URETHROPLASTY?
David BOLONG and Sigfred Ian ALPAJARO
University of Santo Tomas Hospital, Department of Surgery Section of Urology, Manila, PHILIPPINES
PURPOSE
There is no consensus regarding the best procedure in hypospadias repair, and surgical methods continue to evolve,
with introduction of details and techniques to improve the results. This study aims to compare the overall complication
rates and incidence of urethrocutaneous fistula between use of dartos and tunica vaginalis barrier flap in urethroplasty.
MATERIAL AND METHODS
Chart review of all patients undergoing repair for mid and distal penile hypospadias was performed. All patients
underwent tubularized incised plate technique, with 2-layer polyglactin subepithelial closure for the neourethra. One
hundred and twenty patients had a dartos flap barrier and 62 had tunica vaginalis flap barrier. Spongioplasty and skin
closure was then performed. Complications (meatal stenosis, meatal regression, chordee, and penile skin necrosis) and
incidence of fistula were noted.
RESULTS
From 2012-2014, a total of 182 consecutive patients with mid and distal penile hypospadias underwent repair by a
single surgeon. The overall complication rate were 45% and 22.5%, and incidence of fistula were 17.5% and 4.8% for
the dartos and tunica vaginalis barrier flap, respectively.
CONCLUSIONS
Tubularized Incised Plate in with tunica vaginalis flap appear to be superior to dartos flap as a second layer, improving
overall complication rates, and in particular, decreasing incidence of urethrocutaneous fistula.