Objective: To compare the anti-urinary fistula effect of different
dartos tissues used in Snodgrass urethroplasty to cover the new
Methods: From January 2010 to October 2011, 44 cases of
hypospadias patients underwent Snodgrass urethroplasty, aged
from 2.5 to 31 years old, including 7 cases of coronal, 35 cases
of distal penile shaft, and 2 cases of penoscrotal hypospadias.
There were the first operations of all the patients. Correction of
chordee penis was performed during operation, after the urethral
plate had been tubularized to construct a new urethra, different
vascularized dartos tissues were used to cover the new urethra.
There were 16 cases in group A, the new urethra was covered by
either preputial or scrotal dartos on one side. And there were 14
patients were in group B, dorsal preputial dartos flap was graft
to ventral penis with hole opening in centre at the proximal end
to cover urethra. Group C included 22 cases, dorsal preputial
dartos flap was graft with an incision was made in the middle of
the flap. And then the flap wound behind the ventral penis from
two sides respectively to cover the new urethra in two layers.
Urethral silicone stent was used in all patients for 12-14 days.
Results: Follow up lasted for 2 to 22 months, the appearance
of the penis was fine, the external urethral orifice presents as
a vertical slit, was circular cone-shaped, urinary stream was
normal, and no significant penile curvature and urethral stricture
was observed. There were 7 cases of urinary fistula that 3 cases
(18.75%) in group A, 3 cases (21.43%) in group B, and 1 cases
(4.54%) in group C.
Conclusions: Dorsal preputial dartos flap used for two-layer
covering in Snodgrass urethroplasty method can significantly
reduce the incidence of urinary fistula.