The Use of Tunica Vaginalis in Hypospadias Fistula Repair | ||
| Medical Journal of Babylon | ||
| Article 1, Volume 12, Issue 3, September 2015, Pages 739-744 | ||
| Authors | ||
| Ahmed Ali Hassan Al-Kinani; Redha Ali Taher | ||
| Abstract | ||
| In hypospadias surgery urethrocutaneous fistula is the most common complication, or might be an iatrogenic fistula as part of the staged hypospadias repair. Carrying a supportive layer of vascularized tissue for closure between the urethra and the skin will provide safe closure and reduce the likelihood for fistula recurrence. Evaluation of hypospadias fistula closure by using tunica vaginalis fascia as an interpositional layer between the neourethra and the skin to prevent fistula recurrence. The tunica vaginalis fascia vascularized flap have been used for repair of hypospadias fistula. In 50 patients with age ranged from 1.5-15 years, from 2004 to the January 2015. All patients had undergone previous hypospadias repair, the fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested through scrotal incision ,then the skin closed as a third layer of closure. A urethral catheter was kept for urinary diversion for 10-14 days.The repair was successful in all patients excepting only 6 cases where other factors affecting the repair, including catheter obstruction and direct trauma to the operation site. The repair with tunica vaginalis is very effective, so fistulae should be closed in three layers for better healing and preventing the recurrence to the lower minimum. | ||
| Keywords | ||
| Hypospadias; Tunica vaginalis; Urethrocutaneous fistula; Dartos muscle and fascia | ||
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