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390058

Enhancing Tubularized Incised Plate (TIP) Technique for Hypospadias Repair: The Role of Tunica Vaginalis Flap in Minimizing Urethrocutaneous Fistula

Article

Last updated: 24 Dec 2024

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Abstract

Background: Tubularized incised plate (TIP) is the most popular technique performed in hypospadias without chordee. However, it is occasionally associated with some complications such as meatal stenosis, or urethrocutaneous fistula. Recent publications suggest that tunica vaginalis flap (TVF) may enhance the urethroplasty process by providing a robust vascularized tissue bed that supports better healing and reduces complications. Objectives: To evaluate the impact of incorporating a TVF into the TIP technique to cover the urethroplasty tube in patients with deficient ventral skin, assessing its effectiveness in improving surgical outcomes and minimizing urethrocutaneous fistula. Patients and Methods: This is a retrospective study involving 18 patients operated upon by TIP urethroplasty technique using TVF as an intermediate protective layer. Operative findings were collected including urethral plate length, pre urethrotomy plate width, post urethrotomy plate width and tunica flap width and length. Also, postoperative complications and follow-up data were evaluated. Results: The most common form of hypospadias was mid-penile, found in 55.6% of cases. The pre-urethrotomy mean urethral plate width was 7.06 mm, increasing to 13.5 mm post-incision, and the mean tunica flap width was 21.5 mm. Complications were relatively low; no fistula or dehiscence occurred; however, meatal stenosis occurred in 22.2% of patients, managed by either dilatation or meatoplasty. Conclusion: Incorporating tunica vaginalis flaps into TIP urethroplasty may represent a significant additional step over the standard technique in selected cases. The use of TVF is an effective means to enhance surgical outcomes and to minimize rates of urethrocutaneous fistula and repair disruption.

DOI

10.21608/ejhm.2024.390058

Keywords

Tip, hypospadias, Tunica vaginalis flap, urethrocutaneous fistula

Volume

97

Article Issue

1

Related Issue

50804

Issue Date

2024-10-01

Receive Date

2024-11-02

Publish Date

2024-10-01

Page Start

3,862

Page End

3,865

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_390058.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=390058

Order

64

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Enhancing Tubularized Incised Plate (TIP) Technique for Hypospadias Repair: The Role of Tunica Vaginalis Flap in Minimizing Urethrocutaneous Fistula

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Type

Article

Created At

24 Dec 2024