Preliminary experience using a tunica vaginalis flap as the dorsal component of Bracka's urethroplasty
Luke Harper1, Jean-Luc Michel1, Frederique Sauvat1
1Department of Pediatric Surgery, CHU F Guyon, Bellepierre, Saint-Denis de La Réunion, Réunion Island, France.
Objective:
To evaluate clinical use of a tunica vaginalis flap as the dorsal component of a two-stage urethroplasty in boys with cripple hypospadias.
Patients And Methods:
We performed the first stage of a Bracka two-stage urethroplasty, using a tunica vaginalis flap as the dorsal component in six boys with cripple hypospadias. We analysed their clinical characteristics and the results of this technique.
Results:
The mean (range) age of the boys was 57 (34-120) months. The mean (range) number of previous procedures the boys had undergone was 4 (3-5). At the 6-month follow-up, all the boys presented significant fibrosis of the dorsal graft rendering it unusable for tubularisation.
Conclusions:
Exposure to the external environment seems to induce retraction and fibrosis of the tunica vaginalis. We believe one should be very cautious about using tunica vaginalis as the dorsal component of a two-stage urethroplasty, as significant fibrosis might well render the flap unusable.
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