Outcome Between Dartos Fascia and Tunica Vaginalis Flap in Tubularized Incised Plate Urethroplasty for Distal Penile Hypospadias Repair

Abstract

Tubularized incised plate urethroplasty (TIPU) is a widely employed technique for the surgical repair of distal penile hypospadias, aimed at enhancing both functional and cosmetic outcomes while minimizing postoperative complications. Adequate soft tissue coverage of the neourethra is critical to reducing complications, yet no standard covering technique has been definitively established. This quasi-experimental study compared the efficacy of tunica vaginalis flap (Group A) and dartos fascia (Group B) as soft tissue covers in TIPU. Conducted at the Department of Urology, Dhaka Medical College and Hospital, from January 2021 to June 2022, the study involved 41 patients who underwent TIPU for distal penile hypospadias, with 21 patients in Group A and 20 in Group B, selected through purposive sampling. Postoperative follow-ups were conducted at 5 days, 10 days, 1 month, 3 months, and 6 months. Data were analyzed using SPSS 24. The mean age was 5.8±2.1 years for Group A and 4.9±2.1 years for Group B (p>0.05). Initial wound infection at the 5th postoperative day was significantly lower in Group A (4.8%) compared to Group B (20%). Over follow-up periods, Group A demonstrated markedly lower rates of wound infection (14.3% vs. 50%) and urethro-cutaneous fistula formation (14.3% vs. 45%) than Group B (p0.05). The study concludes that tunica vaginalis flap provides superior postoperative results compared to dartos fascia in TIPU for distal penile hypospadias, indicating its potential as the preferred choice for soft tissue coverage.