Comparison Between Dorsal and Ventral Dartos Flap Interposition in A Tubularized Incised Plate Repair of Distal Hypospadias

2020 ◽  
Vol 12 (sp2) ◽  
Keyword(s):  
Tubularized Incised Plate ◽  
Dartos Flap ◽  
Distal Hypospadias

scholarly journals Preputial Dartos Reinforced Snodgrass Tubularized Incised Plate Urethroplasties in Distal Hypospadias to Prevent Urethrocutaneous Fistula

2015 ◽  
Vol 3 (1) ◽  
pp. 12-17
Author(s):  
Md Shah Alam Talukder ◽  
Debesh Ch Talukder ◽  
Md Abdullah Al Mahmud ◽  
Mohammed Showkot Ali ◽  
Nadiuzzaman Khan ◽  
...  
Keyword(s):  
Urethrocutaneous Fistula ◽  
Cutaneous Fistula ◽  
Medical College ◽  
Tubularized Incised Plate ◽  
Group A ◽  
Dartos Flap ◽  
Distal Hypospadias ◽  
Group B ◽  
Hypospadias Surgery ◽  
Fistula Prevention

Urethro cutaneous fistula( U-C fistula) is the most common complication of hypospadias surgery. It frequently needs separate surgeries for closure, which bring a great deal of physical and mental agony and monetary involvement of the patient and his family. Many efforts have been invented to prevent the u-c fistula with various degree of success. We would like to see the outcome of “Preputial Dartos Reinforced Snodgrass Tubularized Incised Plate Urethroplasties in Distal Hypospadias to Prevent Urethrocutaneous Fistula”. This interventional study was performed to see the outcome of preputial dartos reinforced Snodgrass tubularized incised plate urethroplasties in distal hypospadias specially urethrocutaneous fistula prevention. For this purpose 40 patients were selected having distal hypospadias age ranging from 6 months to 11 years admitted in the Department of Pediatric Surgery, Mymensingh Medical College & Hospital during the period of January 2010 to March 2011. Out of 40 patients, 20 were in group-A (preputial dartos flap) and another 20 were included in group - B (without flap). All this patients were followed by perioperative and postoperative care. Few patients developed postoperative pyrexia, wound infection, stent blockage which were treated accordingly leaving minimum morbidity. Both groups of patients were followed up for 3 months after surgery. Present study is probably a better technique to prevent fistulaassociated morbidities in distal Snodgrass TIP urethroplasties.J. Paediatr. Surg. Bangladesh 3(1): 12-17, 2012 (January)

scholarly journals A Comparative Study to Evaluate the Outcome of Double Dartos Flap in Tubularized Incised Plate Urethroplasty for Distal Hypospadias Repair

2015 ◽  
Vol 3 (2) ◽  
pp. 65-70
Author(s):  
Abhi Kumar Chakraborty ◽  
Sajal Kumar Majumdar ◽  
Mirza Kamrul Zahid ◽  
Sayed Mahmudur Rahman ◽  
Dipankar Kumar Saha ◽  
...  
Keyword(s):  
Double Layer ◽  
Fistula Formation ◽  
Hypospadias Repair ◽  
Tubularized Incised Plate ◽  
Superficial Skin ◽  
Group A ◽  
Dartos Flap ◽  
Tubularized Incised Plate Urethroplasty ◽  
Distal Hypospadias ◽  
Group B

Background/purpose: The tubularized incised plate urethroplasty (Snodgrass technique) presents the procedure of choice for distal hypospadias repair. Fistula formation is the most common complication with various rates. Avoiding overlap of suture lines in the Snodgrass repair is critical to minimize fistula formation through second-layer coverage of the neourethra. We compared the outcome of double- layer dartos flaps to flapless procedure in the tubularized incised plate urethroplasty for distal hypospadias repair to assess the effectiveness of dartos flap in this method.Methods: Our study included 28 patients aged upto 12 years who were treated with tubularized incised plate urethroplasty for distal hypospadias in Shaheed Suhrawardy Medical College Hospital from April 2010 to December 2011. They were divided into two groups. Group A (14 patients) had double dartos flap coverings. Group B (14 patients) had no dartos flap covering. The dissected dorsal dartos flap was bisected vertically to form two pedicle wings. Each wing was rotated laterally from either side of the glans to cover the neourethra ventrally in a double-layer fashion.Result: Mean follow up period was 9 months. In Group A, one patient (7%) developed fistula and one (7%) superficial skin necrosis. On the other hand three (21%) patients developed fistula and one patient (7%) meatal stenosis in group B, who were treated with Snodgrass procedure without using dartos flap. All successful repaired hypospadias patients of both groups had a cosmetically normal looking circumcised penis with ventrally slit meatus.Conclusions : Double dartos flaps covering of the neourethra is a simple procedure and could be effective for the prevention of urethrocutaneous fistula after tubularized incised plate urethroplasty.J. Paediatr. Surg. Bangladesh 3(2): 65-70, 2012 (July)

Midshaft Hypospadias: Review of Surgical Technique

2019 ◽  
Author(s):  
Erin R. McNamara ◽  
Bryan Sack ◽  
Alan B. Retik
Keyword(s):  
Surgical Technique ◽  
Key Words ◽  
Common Type ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Tubularized Incised Plate ◽  
Dartos Flap ◽  
Tubularized Incised Plate Urethroplasty ◽  
Skin Coverage

Surgical technique for midshaft hypospadias has evolved since the time of Horton and Devine. The most common type of repair that is currently used is the tubularized incised plate urethroplasty, which is a modification of the Thiersch-Duplay hypospadias repair. The authors review the steps of this procedure in detail and discuss troubleshooting for issues that may arise during the repair. Alternatives for chordee correction and skin coverage are reviewed. The authors briefly discuss outcomes and possible complications. In addition, there is a step-by-step video of a midshaft hypospadias repair that highlights the surgical technique. This review contains 9 figures, and 23 references. Key Words: chordee, dartos flap, hypospadias, midshaft hypospadias, surgical technique, tubularized incised plate (TIP), urethrocutaneous fistula, ventral curvature

scholarly journals Using prepucial mucous to cover neourethra in TIP urethroplasty: 4 years experience in a tertiary paediatric hospital of Bangladesh

2020 ◽  
pp. 37-40
Author(s):  
Sabbir Karim ◽  
◽  
Monoarul Islam Talukder ◽  
Sultana Parvin ◽  
◽  
...  
Keyword(s):  
Conflict Of Interest ◽  
Wide Spectrum ◽  
Urethrocutaneous Fistula ◽  
Urethral Plate ◽  
Paediatric Hospital ◽  
Tubularized Incised Plate ◽  
Dartos Flap ◽  
Key Words Hypospadias ◽  
The Mean ◽  
Different Tissues

Background. Hypospadias has a wide spectrum of penile abnormality requiring surgical correction. Most of the cases are of anterior variety and the surgical technique depends on constructing a neo urethra. Snodgrass or Tubularized Incised Plate (TIP) urethroplasty is one of the most popular techniques of urethroplasty which depends on the existing healthy, adequate and intact urethral plate. Different tissues have been described to cover the neourethra as second layer in literature. In this study we modified the TIP urethroplasty by covering the neourethra with 2 layers of pedicled prepucial mucosa or Dartos flap. Objective. To see the outcome of modified Snodgrass or TIP urethroplasty in anterior mid and proximal penile hypospadias. Materials and method. Total 88 patients were operated by modified Snodgrass technique or modified TIP urethroplasty from January 2012 to July 2016. Coronal, subcoronal, distal penile, mid penile and proximal penile hypospadias were included in the study. Every patient underwent modified TIP urethroplasty and outcomes were assessed. Results. The mean age of the patients were 28.34±14.98 months, ranges from 6.5 to 65 months. 9 (10.2%) patients of our series develop urethrocutaneous fistula, 5 (5.68%) patients develop meatal stenosis and 1 (1.1%) patient developed neourethral stricture. Conclusion. TIP urethroplasty is a versatile method to correct penile hypospadias. Covering of the neourethra with prepucial mucosa secure the neourethral anastomosis. The author declares that there is no conflict of interest. Key words: Hypospadias, TIP urethroplasty, Prepucial mucosa.

scholarly journals Postoperative outcomes in distal hypospadias: a meta-analysis of the Mathieu and tubularized incised plate repair methods for development of urethrocutaneous fistula and urethral stricture

2019 ◽  
Vol 35 (11) ◽  
pp. 1301-1308 ◽  
Author(s):  
Hans Winberg ◽  
Einar Arnbjörnsson ◽  
Magnus Anderberg ◽  
Pernilla Stenström
Keyword(s):  
Urethral Stricture ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Urethrocutaneous Fistula ◽  
Levels Of Evidence ◽  
Tubularized Incised Plate ◽  
Postoperative Fistula ◽  
Distal Hypospadias ◽  
Based Medicine

Abstract Purpose To compare the two major complications, namely postoperative urethrocutaneous fistula and urethral stricture, between the Mathieu and tubularized incised plate (TIP) repair methods for distal hypospadias. Methods In this meta-analysis, electronic databases were searched for comparative studies on the two techniques. The Oxford Centre for Evidence-based Medicine Levels of Evidence was used to evaluate the included studies. The main outcome measure was the frequency of postoperative fistula and urethral stricture. RevMan 5.3 was used for statistical analyses, with P < 0.05 indicating statistical significance. Results A total of 17 studies, which included 1572 patients, met the inclusion criteria. The frequency of urethrocutaneous fistula did not differ between the Mathieu [115 (13%)] and TIP [90 (13%)] methods [odds ratio (OR) 1.1, 95% confidence intervals (CI) 0.6–1.9; P = 0.73)]. Urethral stricture was less frequent after the Mathieu [15 (2%)] method than after the TIP [37 (5%)] method (OR 0.5, 95% CI 0.3–0.8; P < 0.01), even after the subgroup analysis of eight randomized controlled trials was included. Overall, the quality of the included studies was determined to be satisfactory. The levels of evidence on which this review was based ranged from 1b to 2b using the CEBM Levels of Evidence. Conclusion Compared with TIP repair, Mathieu repair for hypospadias had a significantly lower risk for urethral stricture; however, the risk for urethrocutaneous fistula was similar.

Sign in / Sign up

Export Citation Format

Share Document