Comparison of outcome of single versus double Dartos layer for preventing fistula in Tubularized incised plate repair of distal hypospadias.

Abstract

Objective: To compare urethrocutaneous fistula rates between single and double Dartos flap coverage in TIP urethroplasty for distal hypospadias. Study Design: Parallel-group, Randomized Controlled trial. Setting: The Children’s Hospital and Institute of Child Health in Lahore. Period: 01-01-2021 to 12-03-2022. Methods: Out of 150 boys with distal hypospadias, the requisite inclusion & exclusion criteria were applied and 150 were assigned to 2 equal (n=75) groups, with randomization. Group A had TIP repair with single Dartos layer coverage, while Group B had double Dartos layer coverage. Postoperative care was standardized in all groups and included 5 days of IV antibiotics and catheter removal on postoperative day 10. 1, 2, 4, 12, 24, 36 and 54 week follow up were conducted. The main measure of success was the formation of urethrocutaneous fistula. Results: In the single Dartos group, 12% developed fistulas, compared with 4% in the double Dartos group, showing a clinically significant trend in favor of double-layer coverage. Conclusion: Double Dartos flap coverage in distal hypospadias repair seems to decrease the risk of urethrocutaneous fistula formation in comparison to single-layer coverage.