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The Value of Double Dartos Flaps to Protect Tubularized Incised Plate Urethroplasty - Abstract

Mohamed Ramadan Abdallah, Mohamed Ibrahim Naga, Ashraf A. Alnosair, Ahmed H. Al-Salem



Background: The TIP procedure has become the procedure of choice to repair a variety of hypospadias without chordee. The TIP procedure was however associated with a relatively high incidence of fistula and a variety of techniques were adopted in an attempt to reduce this. This is a review of our experience with TIP procedure and protective double dartos flaps.

Methods: Over a 6-year period (June 2008- June 2013), 98 children with hypospadias underwent TIP urethroplasty with double dartos flaps. Their records were reviewed for type of hypospadias, technique of repair, hospital stay and complications.

Results: 98 children with hypospadias (44 coronal, 29 subncoronal, 5 distal penile, 7 mid-penile and 3 proximal penile) had TIP repair which was reinforced with double dartos flaps. Their age at the time of repair ranged from 5 month -7 years and 3 months (mean 2.4 years). On follow-up ranging from 9 months-2 years (mean 1.5 years), 3 (3.1%) developed fistula and 2 (2%) developed mild meatal stenosis that responded to dilatation.

Conclusions: TIP urethroplasty with double dartos flaps is safe and simple single-stage operation in the management of different types of hypospadias without chordee. It has good functional and cosmetic outcome and low complication rates.


Key words: hypospdias, urethroplasty, tubularized incised urethroplasty, Dartos flap, fistula, stenosis