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Doctoral Thesis | General Surgery | India | Volume 11 Issue 12, December 2022 | Rating: 4.8 / 10
Comparison of Dartos Island Flap Vs Corpus Spongiosum Tissue Covering Over Urethroplasty in Distal Penile Hypospadias
Puneet Srivastava | Richa Jaiman [3] | Ankit Singh [4]
Abstract: Introduction: Hypospadias is a congenital deformity characterized by an abnormally located urethral opening anywhere proximal to its normal location on the ventral surface of the penis or into the perineum.TIP procedure (Distal tubularized incised plate) is one of the most common surgical technique used worldwide for hypospadias repair. Urethrocutaneous fistula is most common reported surgical complication after hypospadias repair. The recurrence rate of fistula may be minimized by interposition of multiple well vascularised non-epithelialised layer such as redundant dartos tissue or scrotal based tunica vaginalis flap. The aim of our study was to compare the efficacy of a dartos pedicled flap coverage versus corpus spongiosum tissue covering in reduction of fistula rate after hypospadias surgery. Material and Methods: This prospective randomized study was conducted from Dec. 2018 to Dec. 2020 in all patients of distal and mid hypospadias who were admitted and operated in pediatric surgery unit and uro-surgery unit in the department of General Surgery, S. N. Medical College ,Agra. The study was carried out on 50 patients of distal penile hypospadias. They were divided into 2 groups on random basis depending upon the type of operation performed to form the deficient urethral tube (25 patients in each).The results of the two groups were then compared in terms of complications and cosmetic outcome and analyzed statistically. Discussion: Based on our results and the review of literature, we suggest that the dorsal dartos flap covering should be used as an integral part of the Snodgrass procedure. A longitudinal, well-vascularized dartos flap, harvested dorsally and buttonholed ventrally, represents a good choice for preventing fistula over the corpus spongiosum covering only. Conclusion: Use of dartos flap to cover over with urethroplasty significantly reduces the fistula rate.
Keywords: dartos island flap, corpus spongiousum flap,distal penile hypospadias
Edition: Volume 11 Issue 12, December 2022,
Pages: 145 - 147