Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study
Background: In the tubularized incised plate (TIP) procedure, flap interposition between the skin and neourethra is highly recommended to decrease the postoperative fistula rate. However, there is no consensus regarding the ideal flap for this procedure. This study aimed to report our experiences i...
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PAGEPress Publications
2022-06-01
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| Series: | Archivio Italiano di Urologia e Andrologia |
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| Online Access: | https://www.pagepressjournals.org/index.php/aiua/article/view/10491 |
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| author | Faisal Ahmed Hossein-Ali Nikbakht Khalil Al-Naggar Saleh Al-Wageeh Qasem Alyhari Saif Ghabisha Ebrahim Al-Shami Menawar Dajenah Waleed Aljbri Fawaz Mohammed Abdu Al-Hajri |
| author_facet | Faisal Ahmed Hossein-Ali Nikbakht Khalil Al-Naggar Saleh Al-Wageeh Qasem Alyhari Saif Ghabisha Ebrahim Al-Shami Menawar Dajenah Waleed Aljbri Fawaz Mohammed Abdu Al-Hajri |
| author_sort | Faisal Ahmed |
| collection | DOAJ |
| description |
Background: In the tubularized incised plate (TIP) procedure, flap interposition between the skin and neourethra is highly recommended to decrease the postoperative fistula rate. However, there is no consensus regarding the ideal flap for this procedure. This study aimed to report our experiences in the one-stage TIP hypospadias surgery utilizing dartos flap (DF) (penile skin subcutaneous tissue) and tunica vaginalis flap (TVF) (parietal layer of the testis) as a tissue coverage of neourethra. Methods: In a retrospective study from Sep 2018 to May 2021, 16 cases of hypospadias with different types, ranging from midpenile to penoscrotal types, were managed with TIP urethroplasty using DF or TVF as a tissue coverage of neourethra were enrolled. The demographic characteristics of the participants, type of hypospadias, outcome, and complications were analyzed and compared. Results: We used TVF and DF as soft tissue coverage in 11 (68.8%) and 5 (31.3%) patients, respectively. The mean age was 56.38 ± 47.83 months. Mid-penile, proximal, and penoscrotal hypospadias were presented in 3 (18.8%), 8 (50.0%), and 5(31.2%) patients, respectively. The total success rate was 14 (87.5%), while 2 (12.5%) patients developed a urethrocutaneous fistula, which required delayed closure later. In comparison between TVF and DF groups: the TVF was applied in all patients with moderate and severe chordee and all patients with penoscrotal hypospadias, and six patients with proximal hypospadias, while only three patients with mild chordee and two patients with proximal hypospadias used the DF and showed statistical significance between groups (p < 0.001 and 0.012) respectively. The success rate was 90.9% vs. 80.0% in TVF and DF groups, respectively, with no statistical significance between groups (p = 1.000). Conclusions: In the primary TIP repair, the TVF is a practical option as a DF for the interposition cover of a neourethra, especially in penoscrotal and proximal hypospadias with severe chordee.
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| first_indexed | 2024-04-12T09:47:01Z |
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| language | English |
| last_indexed | 2024-04-12T09:47:01Z |
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| spelling | doaj.art-da6d3365c02f4c6b9e13cce6610474992022-12-22T03:37:56ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972022-06-0194210.4081/aiua.2022.2.206Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric studyFaisal Ahmed0Hossein-Ali Nikbakht1Khalil Al-Naggar2Saleh Al-Wageeh3Qasem Alyhari4Saif Ghabisha5Ebrahim Al-Shami6Menawar Dajenah7Waleed Aljbri8Fawaz Mohammed9Abdu Al-Hajri10Urology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, IbbSocial Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, BabolUrology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, IbbDepartment of General Surgery, School of Medicine, Ibb University of Medical Science, IbbDepartment of General Surgery, School of Medicine, Ibb University of Medical Science, IbbDepartment of General Surgery, School of Medicine, Ibb University of Medical Science, IbbUrology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, IbbDepartment of General Surgery, School of Medicine, Ibb University of Medical Science, IbbDepartment of Urology, School of Medicine, 21 September University, Sana'aDepartment of Orthopedy, School of Medicine, Ibb University of Medical Science, IbbDepartment of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb Background: In the tubularized incised plate (TIP) procedure, flap interposition between the skin and neourethra is highly recommended to decrease the postoperative fistula rate. However, there is no consensus regarding the ideal flap for this procedure. This study aimed to report our experiences in the one-stage TIP hypospadias surgery utilizing dartos flap (DF) (penile skin subcutaneous tissue) and tunica vaginalis flap (TVF) (parietal layer of the testis) as a tissue coverage of neourethra. Methods: In a retrospective study from Sep 2018 to May 2021, 16 cases of hypospadias with different types, ranging from midpenile to penoscrotal types, were managed with TIP urethroplasty using DF or TVF as a tissue coverage of neourethra were enrolled. The demographic characteristics of the participants, type of hypospadias, outcome, and complications were analyzed and compared. Results: We used TVF and DF as soft tissue coverage in 11 (68.8%) and 5 (31.3%) patients, respectively. The mean age was 56.38 ± 47.83 months. Mid-penile, proximal, and penoscrotal hypospadias were presented in 3 (18.8%), 8 (50.0%), and 5(31.2%) patients, respectively. The total success rate was 14 (87.5%), while 2 (12.5%) patients developed a urethrocutaneous fistula, which required delayed closure later. In comparison between TVF and DF groups: the TVF was applied in all patients with moderate and severe chordee and all patients with penoscrotal hypospadias, and six patients with proximal hypospadias, while only three patients with mild chordee and two patients with proximal hypospadias used the DF and showed statistical significance between groups (p < 0.001 and 0.012) respectively. The success rate was 90.9% vs. 80.0% in TVF and DF groups, respectively, with no statistical significance between groups (p = 1.000). Conclusions: In the primary TIP repair, the TVF is a practical option as a DF for the interposition cover of a neourethra, especially in penoscrotal and proximal hypospadias with severe chordee. https://www.pagepressjournals.org/index.php/aiua/article/view/10491Hypospadias; Dartos Fascia; Tunica Vaginalis; Tubularized Incised Plate. |
| spellingShingle | Faisal Ahmed Hossein-Ali Nikbakht Khalil Al-Naggar Saleh Al-Wageeh Qasem Alyhari Saif Ghabisha Ebrahim Al-Shami Menawar Dajenah Waleed Aljbri Fawaz Mohammed Abdu Al-Hajri Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study Archivio Italiano di Urologia e Andrologia Hypospadias; Dartos Fascia; Tunica Vaginalis; Tubularized Incised Plate. |
| title | Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study |
| title_full | Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study |
| title_fullStr | Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study |
| title_full_unstemmed | Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study |
| title_short | Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study |
| title_sort | role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair a retrospective monocentric study |
| topic | Hypospadias; Dartos Fascia; Tunica Vaginalis; Tubularized Incised Plate. |
| url | https://www.pagepressjournals.org/index.php/aiua/article/view/10491 |
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