The outcome of Tunica Vaginalis flap in Hypospadias repair


Background: Putting vascularized flaps over the neourethra is indicatedin hypospadias surgery. This will lessen the complications rate, mostlythe urethrcutaneous fistula, this is more indicated in secondary andcomplicated cases.The study’s Aim: To assess our initial experience with tunica vaginalisflap (TVF) in proximal primary and secondary hypospadias.Materials and methods: This study prospectively included secondaryand primary proximal hypospadias which are corrected using tubularizedincised plate (TIP). The age of the patient, type of hypospadias,complications of primary repair, complications of our repair and thefollow up results were reported.Results: Between December 2011 to December 2018, 33 children withprimary proximal or failed cases were repaired using TIP with the use of(TVF) interposition. Seventeen cases were primary with peno-scrotalopening repaired by single stage (Group A).Sixteen cases were secondary hypospadias (Group B), 5 of them haddistal opening as their original pathology while the remaining 11 caseshad peno-scrotal opening with complete dehiscence of the previousrepair.The follow-up time extended from 2 to 60 months, Group A (n=17); 4cases (23%) developed Urethral fistula and 2 cases (12%) developedMeatal Stenosis. While in Group B (n=16); 3 cases (19%) developedfistula and 3 cases (19%) developed Meatal Stenosis. Only one case(6%) developed glandular dehiscence. The scrotum was obviouslynormal in both groups.Conclusion: TVF looks to be good interposition layer and good optionin crippled and proximal hypospadias. It is a vascularized layer thatcould cover any urethroplasty length.