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Tunica vaginalis onlay urethroplasty as a salvage repair
1Department of Surgery, University of Alabama at Birmingham Children's Hospital, USA.
Purpose:
We review our experience with tunica vaginalis onlay urethroplasty for urethral repair after multiple previous hypospadias repairs.
Materials And Methods:
From January 1992 through December 1997 we repaired the urethra in 10 boys and 1 man using a tunica vaginalis onlay flap. The tunica vaginalis was placed as a patch on the urethra that was proximal to the glans or brought out to the urethral meatus.
Results:
No intraoperative complications or difficulties were associated with harvesting the tunica vaginalis. Of the 4 children and 1 adult in whom the onlay flap was brought out to the urethral meatus meatal stenosis developed in 3 (60%), while 2 void without problems. In 6 children the onlay flap was placed proximal to the glans and in 1 who was lost to followup 2 discontinuous patches were placed. In 3 of the 5 remaining boys (60%) stricture developed, while 2 void without problems.
Conclusions:
Tunica vaginalis onlay urethroplasty results in a substantial complication rate. We did not confirm any advantage of its use.