Comparison of dartos flap and dartos flap plus spongioplasty to prevent the formation of fistulae in the snodgrass technique

Objective The aim of our study was to evaluate the role of paraurethral spongial tissue plus dartos flap using an additional urethral cover to prevent fistula formation in patients who underwent surgery with the Snodgrass technique. Patients and methods A retrospective study was performed on 161 patients aged 10 months to 15 years who underwent midpenile and distal hypospadias repair using the Snodgrass technique. The patients were assigned to one of two groups. In Group I (75 patients), the neourethra was covered with the dartos flap, and in Group II (86 patients), the neourethra was covered with the dartos flap plus spongioplasty. Results Urethral fistulae were encountered in six cases (8%) in Group I, and no fistulae were encountered in Group II. Conclusion The use of corpus spongiosum as an intermediate layer in urethral coverage, combined with the dartos flap, reduces the likelihood of fistula formation. This procedure can be applied easily and effectively to prevent the formation of fistulae. © 2011 Springer Science+Business Media, B.V.