Tunica Vaginalis vs. Dartos Flap for Penile Hypospadias
Purpose
This study compares two methods—dartos flap (DF) and tunica vaginalis flap (TVF)—used to cover the urethra in children with distal or mid-shaft penile hypospadias after surgery.
Methods
The trial involved 88 children, excluding those with previous surgeries like orchiectomy or hernia repair. They were randomly assigned to either the DF group or the TVF group. The main goal was to see how often urethrocutaneous fistulas occurred. A secondary goal was to evaluate cosmetic results using specific scoring systems.
Results
Both groups had similar baseline characteristics. The average surgery time was shorter for the DF group (100 minutes) compared to the TVF group (145 minutes). Fistulas were more common in the DF group (20.9%) than in the TVF group (4.9%). Other complications included meatal stenosis and penile torque, but these were not significantly different between the groups. The TVF group had better scores in cosmetic evaluations.
Conclusion
The tunica vaginalis flap significantly reduces the risk of fistulas compared to the dartos flap, although it requires more time to perform.
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