Limitations and Complications of Tunica vaginalis flap as an interposition layer in Hypospadias : A Hospital Based Study

Bhatnagar Amit; Kansal Sandeep; Monga Y.P; Chauhan Adarsh

Volume : VI, Issue : IX, September - 2017

Limitations and Complications of Tunica vaginalis flap as an interposition layer in Hypospadias : A Hospital Based Study

Bhatnagar Amit, Kansal Sandeep, Monga Y. P, Chauhan Adarsh

Abstract :

Objective To obtain better outcome of hypospadias repair, it seems that use of a vascularized tunica vaginalis flap as a second layer combined with Snodgrass procedure results in better outcome. This is a prospective study of 25patients conducted during July 2015 to July 2017 to evaluate the limitations and complications of tunica vaginalis vascular flap as second layer in Hypospadias repair and redo surgery. Material and MethodPatients were admitted on outpatient department basis and operated after proper workup. Wound infections/dehiscence, acute bleed, urinary leak, edema, stricture, development of meatal stenosis, scrotal disorders, etc were regarded as surgical complications. A need for repeat surgical intervention (fistula) during the follow–up was considered as a failure.Result Successrate was seen in 24 cases (96%), with 5 cases (20%) developing early / late complications and failure was seen in 1 case (4%). Conclusion Tunica vaginalis has good vascularity, easy availability, not affected by penile disorders, with long pedicle length to vascularise the entire neourethraupto the glans. Tunica vaginalis flap may have a benefit in circumcised patients. Some may feel, harvesting the flap is meticulous, tedious and time consuming requiring a learning curve with risk of injury to testes, vas or spermatic cord or vessels.