A Comparative Study on Ventral Dartos Flap Vs Tunica Vaginalis Flap in Hypospadias Repair, Decreasing the Incidence of Fistula Formation

Abstract

Objective: To compare the effectiveness of the Tunica Vaginalis Flap (TVF) and the Ventral Dartos Flap (VDF) in
reducing fistula formation following distal hypospadias repair in pediatric patients.
Study Design: Quasi-experimental study.
Place and Duration of Study: This study was conducted at the Department of Paediatric Surgery, Pak Emirates
Military Hospital (PEMH), Rawalpindi, Pakistan from January 2023 to December 2024.
Methods: A total of 100 patients under eight years of age with distal hypospadias were recruited. Patients were
randomly divided equally into two groups (TVF vs VDF), using a random numbers table. Data was analyzed using
SPSS version 27, with chi-square tests for categorical variables and independent t-tests for continuous variables
with significance set at P < 0.05.
Results: The mean age of all patients was 2.46±1.210 years, while the mean weight was 11.47 ± 3.115 kg, and
were comparable between groups. During the 6 months follow-up, a total of 25% (N=25 out of 100) patients
developed Urethro Cutaneous Fistula (UCF), with 13% (N=8) in the TVF group and 34% (N=17) in the VDF group,
indicating a statistically significant reduction in fistula formation with tunica vaginalis flap (P=0.038). The
superior vascularity and independent blood supply of TVF likely contributed to improved wound healing and
fewer UCF.
Conclusion: In this study, TVF provides a more trustworthy neourethral coverage than VDF in distal hypospadias
repair, particularly lowering UCF incidence. These results justify the preferred use of TVF for neourethral
coverage to improve surgical outcomes. However, the choice between the two techniques may depend upon
the operating surgeon's preferences and patient-specific factors. Further large-scale studies with extended
follow-up are recommended to validate these results.

How to cite this: Ahmed R, Ashraf Y, Ahmed A, Jabbar MS, Rehman MH, Jarral S. A Comparative Study on Ventral Dartos Flap Vs Tunica Vaginalis Flap in Hypospadias Repair, Decreasing the Incidence of Fistula Formation. Life and Science. 2025; 6(3): 317-323. doi: http://doi.org/10.37185/LnS.1.1.927