Tunica vaginalis reinforcement flap in reoperative Snodgrass procedure

Interposing vascularized flaps between urethra and skin sutures is recommended in hypospadias surgery to decrease the rate of urethrocutaneous fistula. For this purpose nine patients with failed results after at least one hypospadias surgery and with insufficient foreskin were included in the study. Tubularized incised plate uretroplasty and tunica vaginalis reinforcement flap were performed to all patients with normal urethral plate. After a mean follow-up of 8.9 months (range 3-20) only one patient had developed a fistula. We believe that tunica vaginalis reinforcement flap decreases fistulas in reoperative hypospadias surgery in patients with insufficient foreskin or with a circumcised penis.