Biomedical

Comparison of outcome of TIP urethroplasty with or without Buck’s Fascia repair



  Peer Reviewed

Abstract

Objective

Objective TIP is the most common preformed type of Urethroplasty. The intermediate barrier is used as a waterproofing layer to prevent fistula formation. Many tissues have been utilized as a barrier layer, with varying success rates. The search for a better intermediate layer will continue. In this study, we aim to evaluate the role of Buck’s Fascia as a covering for the neo-urethra to prevent fistula formation in patients who underwent Snodgrass Urethroplasty.

Methods

Methods This prospective study was conducted between 2018 and 2022. Patients were randomly assigned to either Group ‘A’ or Group ‘B’. Group A included patients who underwent the Snodgrass procedure with a Buck’s Fascia cover, while Group B included patients whose neo-urethra was covered with the dartos flap. These patients were closely monitored for the development of short- and long-term complications in both groups, and the results were recorded.

Results

Results The study involved 164 patients, who underwent midpenile and distal hypospadias repair using the Snodgrass technique. In Group ‘A’ (84 patients), the neo-urethra was covered with Buck’s Fascia, while in Group ‘B’ (80 patients), the neo-urethra was covered with the dartos flap. The mean age of the children was (23.06 ± 16.12) months in group ‘A’ & (26.06 ± 14.07) months in group ‘B’. Mean operating time was (40 ± 11.43) minutes in Group ‘A and (70 ± 17.43) minutes in Group ‘B’. Meatal stenosis occurred in 3.57% of children in Group ‘A’ and 10% of patients in Group ‘B’. Urethral fistulas were encountered in 2.35% of cases in Group ‘A’ and 10% in Group ‘B’. The difference between the groups was statistically significant.

Key Questions

1. What is Buck’s Fascia used for in urethroplasty?

Buck’s Fascia is used as a covering to prevent fistula formation in urethroplasty procedures, particularly in the Snodgrass technique for hypospadias repair.

2. How does Buck’s Fascia compare to the dartos flap in preventing complications?

When compared to the dartos flap, Buck’s Fascia showed significantly lower rates of complications such as meatal stenosis and urethral fistulas.

3. What are the benefits of using Buck’s Fascia in Snodgrass urethroplasty?

Using Buck’s Fascia as a covering for the neo-urethra results in fewer complications, quicker recovery times, and better long-term outcomes compared to other barrier tissues like the dartos flap.

4. What complications were observed in the study with Buck’s Fascia?

The study showed that Buck’s Fascia significantly reduced the incidence of meatal stenosis and urethral fistulas compared to the dartos flap, making it a promising choice for urethral reconstruction.