Comparison of double vertical incision with various tubularization techniques and its clinical application

Tubularization is one of the indispensable practices of reconstructive surgery, especially in the repair of hypospadias. In all procedures of forming a tube, the desired diameter should be reached without any complication.

We used as a new technique, 'double vertical incision', in 8 rabbits and compared it with free skin graft, local flap and single vertical incision. We formed 32 tubes randomly around an 8-french catheter using 7/0 PDS suture. Twenty-one days after the operation, the tubes were taken, randomized to staining with hematoxylin and eosin and with Masson's trichrome and then subjected to histopathological examination. Inflammation, fibrosis and lumen diameter were statistically evaluated.

Widest lumen diameters were found in the double incision group and this result was statistically different when compared with the results of the other groups (p < 0.001).

Double vertical incision is promising in that it is easier to perform, provides a desired amount of tissue in cases in which the urethral bed is narrow, and causes no scar. Based on the results we obtained, we applied double vertical incision, a modification of tubularized incised plate urethroplasty popularized by Snodgrass, in 4 patients. The tubes were not distended, their long-term follow-up showed no complication and a urethra of the desired diameter was obtained.