Value of tunica vaginalis flap cover during staged repair of perineal hypospadias

Abstract

Objective To explore the application of tunica vaginalis flap during two-staged repair of perineal hypospadias. Methods The clinical data of 20 patients with perineal hypospadias from October 2011 to March 2014 were retrospectively reviewed. Their mean operative age was 3.5(1.6-11) years. The clinical types were all perineal with severe chordee and penile-scrotal transposition. The mean length of defect urethra was 6.5(6.0-7.5) cm. For stage I, Byars’ approach was adopted and prepuce repositioned ventrally; for stage II, Duplay’s approach was performed 6 months later. After urethroplasty, all of them underwent surgical covering urethra entirely by tunica vaginalis flap. Results A total of 19 patients (95%) were cured initially. And 1 patient (5%) with urethral fistula was managed by another improved operation half a year later. During a follow-up period of 1-3 years, there was no onset of urethral fistulas, stricture or diverticulum. Both penile cosmetics and erection were excellent. Conclusions Staged repair is relatively simple and effective. Tunica vaginalis flap covering urethra may enhance success rate effectively during staged hypospadias repair and minimize urethral fistula postoperatively. Key words: Perineal hypospadias; Tunica vaginalis of testis; Complication