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ORIGINAL ARTICLE
Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 48-51

Tubularized incised plate urethroplasty with dorsal dartos flap cover and asymmetrical prepucial flaps: A valuable option in hypospadias repair?


1 Department of Paediatric Surgery, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
2 Department of Surgery, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India

Correspondence Address:
Dr. Yogender S Kadian
Department of Paediatric Surgery and Surgery, Pt. B.D. Sharma PGIMS, Rohtak, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ais.ais_16_17

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Background: Snodgrass or tabularized incised plate (TIP) repair is the most common technique for distal penile hypospadias cases. However different variations of this procedure have been tried in attempts to reduce the complications. The variations reported are for the cover of the neourethra and creations of prepucial flaps In this study the authors report another variation devised by them in which there is dorsal prepuce is divided into two unequal parts. Patients and Methods: We have managed 35 patients of distal hypospadias without chordee with hypospadias were managed wherein the neourethra was created by incised urethral plate and it was covered by a dorsal dartos flap taken from 1/3rd portion of asymmetrically divided prepuce after discarding its outer layer and rest 2/3rd of the two layered prepuce used to cover the penile shaft. Results: Three (8.57 %) patients developed a fistula at the coronal level, of which one closed spontaneously within three months of repair while two healed after a surgical repair. There was retraction of the meatus in one patient. All the remaining patients had acceptable cosmetic and functional outcome. Conclusion: The tubularized incised plate repair with suggested modification of asymmetrical division of dorsal prepuce and use of dartos flap to cover the neourethrais a good option in select patients of hypospadias without chordee. The advantage is that there is no overlapping of suture lines of the neourethra and skin and it takes care of glanular tilt. However the cosmesis is not as good as in cases where there is symmetrical division of prepucial flaps.


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