Double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula in uncircumcised patients with distal hypospadias.

Raed Al-taher; Mohammad Nofal; Ali J Yousef; Mohammad Rashdan; Amjad Tarawneh; Jad Alsmadi; Eman Hasan; Dalal Alshareefi; Danah Alenezi; Bashayer Abdulrasoul

Return

Double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula in uncircumcised patients with distal hypospadias.

Author: Raed AL-TAHER ¹ ; Mohammad NOFAL ² ; Ali J YOUSEF ² ; Mohammad RASHDAN ¹ ; Amjad TARAWNEH ³ ; Jad ALSMADI ⁴ ; Eman HASAN ¹ ; Dalal ALSHAREEFI ¹ ; Danah ALENEZI ¹ ; Bashayer ABDULRASOUL ¹
Author Information

1. Department of General Surgery, Division of Pediatric Surgery, School of Medicine, The University of Jordan, Amman 11942, Jordan.
2. Department of General Surgery and Anesthesia, School of Medicine, Mutah University, Karak 61710, Jordan.
3. Department of Pediatrics, School of Medicine, Mutah University, Karak 61710, Jordan.
4. Department of General and Special Surgery, Division of Urology, Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan.
Publication Type:Journal Article
Keywords: distal hypospadias; double-layered preputial dartos flap; tubularized incised plate urethroplasty; urethrocutaneous fistula
MeSH: Male; Humans; Infant; Hypospadias/surgery*; Retrospective Studies; Urologic Surgical Procedures, Male/methods*; Urethra/surgery*; Fistula/surgery*; Treatment Outcome
From: Asian Journal of Andrology 2023;25(1):93-97
CountryChina
Language:English
Abstract: Urethrocutaneous fistula may complicate hypospadias repair. We noticed that double-layered preputial dartos flaps added to tubularized incised plate urethroplasty can reduce the risk of urethrocutaneous fistula. The aim of this study was to compare the outcomes of tubularized incised plate urethroplasty with double-layered preputial dartos flaps to with single-layered local fascial flaps in preventing urethrocutaneous fistula. A retrospective cohort study was conducted between January 2017 and December 2020 at Jordan University Hospital (Amman, Jordan). Boys who were aged between 6 months and 5 years, diagnosed with distal hypospadias, and not circumcised were included. The primary outcome was the occurrence of urethrocutaneous fistula in patients who underwent tubularized incised plate urethroplasty with a double-layered fascial flap. The results showed a total of 163 boys with distal hypospadias; among them, 116 patients underwent tubularized incised plate urethroplasty with a single-layered fascial flap, and 47 underwent tubularized incised plate urethroplasty with a double-layered fascial flap. The development of urethrocutaneous fistula was higher in the group receiving tubularized incised plate urethroplasty with a single-layered fascial flap than in the group receiving tubularized incised plate urethroplasty with a double-layered fascial flap after 1 month, 6 months, and 12 months (6.9% vs 0, 10.3% vs 0, and 5.2% vs 0, respectively), and the difference after 6 months was statistically significant (P = 0.02).