Dorsal Dartos Flap in Snodgrass Hypospadias Repair: How to Use it?
Publication Type
Conference Paper

Materials and Methods: The study included twenty sex patients with primary hypospadias,
~~d 2 to 22 years (average 7.86), who were operated from June 2002 to August 2006. Of the
~tiO.pts, twenty one patients had distal, three had midshaft and two had penoscrotal
hypospadias. The standard technique of tubularized incised plate (TIP) with double layers
covering of neourethra by subcutaneous tissues was used in the reconstruction of all cases. A
longitudinal dorsal dartos subcutaneous flap was harvested and dissected from the middle then
both layers of flap were symmetrically transposed to the ventral side of the penis. Each layer
was sutured to the glans wings and to the corpora covernosa thus the neourehtra became
completely covered with double layers of well-vascularized tissue. The mean follow-up
period was 4.5 months (range 3-12 months).
Results: Successful results of normally looking penis without fistula were achieved in all
patients. Only one patient had meatal stenosis (3.84%) at early postoperative period which
was corrected by urethral dilatation of external meatus at interval up to two months
Conclusions: Our technique represents a reasonable option for utilizing dorsal dartos
subcutaneous tissue in TIP urethroplasty. The neourethra is symmetrically covered with
double layer of well vascularized tissue and the penis is kept without rotation. Redundancy of
the flap and its excellent vascularization depend on harvesting technique. Further follow up
and larger number of patients are needed before a final conclusion could be made.

Conference Title
7th Congress of Arab Association of Urology
Conference Country
Conference Date
Nov. 29, 2007 - Dec. 2, 2007
Conference Sponsor
Arab Association of Urology