Dorsal Dartos Flap in Snodgrass Hypospadias Repair: How to Use it?

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Journal Title, Volume, Page: 
Urol Int. 2008;81(2):215-7. doi:10.1159/000144064. Epub 2008 Aug 29.
Year of Publication: 
Mustafa M.
Departments of Urology, Medicana Hospital, Istanbul and Osmaniye State Hospital, Osmaniye, Turkey
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Wadie B.S.
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
Abol-Enein H.
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
Preferred Abstract (Original): 

Purpose: To introduce new technique for covering neourethra with dorsal dartos subcutaneous tissue in Snodgrass hypospadias repair.
Material and Methods: The study included 26 patients with primary hypospadias, aged 2–22 years (average 7.86), operated from June 2002 to August 2006. Of the patients, 21 had distal, 3 midshaft and 2 penoscrotal hypospadias. The standard technique of tubularized incised plate (TIP) with double-layer covering of the neourethra by subcutaneous tissue was used in all cases of reconstruction. The mean follow-up period was 4.5 months (range 3–12 months).
Results: Successful result of a normal-looking penis without fistula was achieved in all patients. One patient had meatal stenosis (3.84%) at the early postoperative period which was corrected by urethral dilatation of the external meatus at an interval of up to 2 months postoperatively.
Conclusion: Our technique represents a reasonable option for utilizing dorsal dartos subcutaneous tissue in TIP urethroplasty. The neourethra is covered symmetrically with a double layer of well-vascularized tissue and the penis is kept without rotation. Redundancy of the flap and its excellent vascularization depend on the harvesting technique. Further follow-up and a larger number of patients are needed before a final conclusion can be made