Study to compare de-epithelized inner preputial skin flap and Dartos fascia flap as water-proofing layer in hypospadias repair by Snodgrass’ Technique

Abstract

We conducted a study to compare two different methods of water proofing in hypospadias repair. All 30 cases in our study were repaired by using Snodgrass technique. In 15 cases water proofing was done using inner preputial de-epithelialized skin flap. This group was named as group A in our study. In another group Dartos fascia was used as water proofing layer. This group was named Group B in this study. The minimum period of follow-up in this series was 18 months. In Group A: One patient had fistula which healed spontaneously. One patient had partial wound dehiscence that resolved on conservative measures. Skin necrosis, meatal stenosis, stricture of neourethra and residual chordee was not seen in this group. One case required catheter removal on 3rd day because of severe bladder spasm. In Group B: Urethrocutaneous fistulae were seen in two cases. One healed by itself but one persisted. Skin necrosis occurred in two cases. One healed spontaneously but in other we have to cover it with scrotum (Cecil-Culp Procedure) to salvage the repair. Meatal stenosis, urethral stricture and residual chordee were not seen in any patient. We conclude that inner preputial de- epithelialized skin flap may have an edge over Dartos fascia for coverage of the neourethra as water proofing layer.