Tunica vaginalis onlay urethroplasty as a salvage repair.

Abstract

We review our experience with tunica vaginalis onlay urethroplasty for urethral repair after multiple previous hypospadias repairs. From January 1992 through December 1997 we repaired the urethra in 10 boys and 1 man using a tunica vaginalis onlay flap. The tunica vaginalis was placed as a patch on the urethra that was proximal to the glans or brought out to the urethral meatus. No intraoperative complications or difficulties were associated with harvesting the tunica vaginalis. Of the 4 children and 1 adult in whom the onlay flap was brought out to the urethral meatus meatal stenosis developed in 3 (60%), while 2 void without problems. In 6 children the onlay flap was placed proximal to the glans and in 1 who was lost to followup 2 discontinuous patches were placed. In 3 of the 5 remaining boys (60%) stricture developed, while 2 void without problems. Tunica vaginalis onlay urethroplasty results in a substantial complication rate. We did not confirm any advantage of its use.