Preputial dartos reinforced Snodgrass tubularized incised plate urethroplasties in distal hypospadias

Abstract

Purpose: The present study was carried out to evaluate the role of preputial dartos soft tissue reinforcement interposition flaps in prevention of persistent urethro-cutaneous fistulas (UCFs) in distal Snodgrass tubularised incised plate urethroplasties (STIPUs). Materials and Methods: During 2005 – 2007, 20 distal hypospadiacs (coronal n= 12, sub coronal n= 8) aged 12-20 years were subjected to STIPUs. After de-epithelialization of both sides of redundant dorsal preputial hoods, the resultant preputial dartos soft tissue flaps were ventralized (similar to Byars, n= 8; Nesbit, n= 8; and, double breasting, n=4) to be interposed between the underlying neo – urethral tubes and the overlying skin covers. Results : All the three modifications of preputial dartos STRIFs functioned highly effectively and only two cases developed micro UCFs both of which healed spontaneously. Conclusion : Prepucial dartos reinforced flaps are ideal for distal hypospadiacs. Micro UCFs developing after routine use of STRIFs, tend to heal spontaneously.