Vol. 8, Issue 1, Part A (2024)

Background: The most frequent complication of hypospadias surgery is the development of fistulas, which necessitates a subsequent surgical procedure. Various methods for supplying vascularized soft tissue coverage to the neourethra have been documented. The components consist of de-epithelized skin, corpus spongiosum, dartos fascia, and tunica vaginalis. The aim of our study was to compare the results of standard tubularized incised plate urethroplasty (TIP) repair employing dartos flap and tunica vaginalis flaps in patients of hypospadias. The tubularized incised plate (TIP) urethroplasty is the predominant method used to address hypospadias. Nevertheless, urethrocutaneous fistula (UCF) remains a prevalent consequence of this procedure. Various methods have been suggested to reduce the occurrence of this problem by supplying vascularized flaps to the neourethra. The objective of the study was to evaluate the results of repairing hypospadias utilizing a tunica vaginalis (TV) flap compared to employing preputial dartos (PD) fascia.

Aim: To compare tunica vaginalis with dartos flap as soft tissue cover in primary hypospadias repair.

Methods: This study was conducted in the Department of Surgery of G S medical college and hospital Hapur. The study focused on patients diagnosed with distal, mid penile, and proximal penile types of hypospadias. The total number of cases examined was 60. A cohort of 30 patients from Group A was intentionally chosen to undergo repair utilizing TVF for the purpose of providing soft tissue coverage. Group B consisted of 30 patients who were similar in age and had the same type of hypospadias. 

Conclusions: The current study observed a greater incidence of fistula formation and skin necrosis in the dartos flap group compared to the tunica vaginalis group. The Tunica vaginalis flap clearly outperforms the preputial dartos flap, and we highly advocate its application as a waterproofing second layer in hypospadias instances.