Tunica vaginalis: an aid in hypospadias surgery

Despite the improvements that have been made in equipment and in the techniques of hypospadias repair, some patients still present with failed repairs and urethral fistulas. In such patients the lack of prepuce leads to difficulty in obtaining adequate tissue for further reconstruction. In 14 patients with hypospadias who had already undergone surgery, a tube was formed from proximal penile or scrotal skin and wrapped by pedicled tunica vaginalis; 4 patients with urethral fistulas were treated in the same way after primary repair of the fistulas. Excellent cosmetic and functional results were achieved in all but 1 case. The technique is simple, has few complications and is recommended in the treatment of patients with failed hypospadias repair and urethral fistulas.