DISTAL PENIL HYPOSPADIAS REPAIR WITH AND WITHOUT DARTOS FASCIA FLAP, A COMPARATIVE STUDY.

Background: Hypospadias is the most common anomaly in male genital tract. The single stage Snodgrass tubularized incised plate (TIP) repair is widely accepted for treatment of distal hypospadias. Objective: To evaluate the efficacy of spongioplasty with or without Dartos flap for treatment of primary hypospadias. Patients and Methods: A prospective study was performed including 40 cases with mid- and distal primary penile hypospadias undergoing TIP from January 2014 to January 2015, at Minia University Hospital, Egypt. The cases were divided into two groups of equal number. In group I, 20 cases underwent TIP without dartos fascia flap. In group II, 20 cases managed by adding a dartos fascia flap as an intermediate layer for covering neourethra after spongioplasty. The assessed parameters were force and caliber of the urinary stream, gapping of the suture line, fistula formation, meatal stenosis, stricture of the urethra, complete disruption of the repair, and post operative bleeding. Results: There was a significant less operative time in group I (46.25 ? 7.58 minutes versus 67.5 ? 15.76 minutes, P < 0.001). There were no significant differences in incidence of intraoperative bleeding (10% and 20% respectively), incidence of urethrocutaneous fistula (10% and 15% respectively), and incidence of meatal stenosis (10% and 5% respectively). Conclusion: Spongioplasty only in TIP repair without using daros flap is relatively safe and rapid technique.