IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 10 Ser.14 (October. 2019), PP 39-44 www.iosrjournals.org DOI: 10.9790/0853-1810143944 www.iosrjournals.org 39 | Page A Comparative Study of Use of Bucks Fascia and Dartos Fascia to Reinforce Urethral Suture Line in Hypospadias Surgery 1. Dr Ashok Laddha, 2. DrVibhav Kumar Soni, 3 .Dr Brijesh Kumar Lahoti, 4 .Dr R.K. Mathur 5 . Dr S.S.Sharma, 6 . Dr Santosh More, 7 Dr Ankit Chorma 1.Associate Professor, division of paediatric surgery, MGMMC, Indore, Madhya Pradesh. 2. resident department of general surgery, MGMMC, Indore, Madhya Pradesh. 3. professor, division of paediatric Surgery, MGMMC, Indore, Madhya Pradesh. 4.Prof & HOD department of surgery, MGMMC, Indore, Madhya Pradesh 5.Associate Professor, department of surgery, MGMMC, Indore, Madhya Pradesh 6.Senior resident,department of surgery, MGMMC, Indore, Madhya Pradesh 7. resident department of general surgery, MGMMC, Indore, Madhya Pradesh Corresponding Author: Drvibhav Kumar Soni C-115 Bhakta war ram Nagar near tilak Nagar post office 452001 Indore (M.P.) Abstract: Purpose: Our purpose is to study the use of buck’s fascia and dartos fascia to reinforce urethral suture line in hypospadias surgery to decrease the fistula rate and post op complications. Introduction:-The most common congenital penile anomaly in children is hypospadias (68./.) followed by chordee (8.6./.) and hypospadias with chordee (5./.). Fistula and glans disruption are still the most frequent complications of hypospadias surgery.Neourethral coverage is a mandatory step in this challenging surgery; it reduces the rate of fistula. This coverage can be bucks fascia, dartos fascia& tunica vaginalis, Glue, etc. there is limited studies how compares dartos fascia with bucks fascia. Material and Method:- Total 100 patients of 1year to 14 year were studied which were divided in two study groups buck’s fascia and dartos fascia group with 50 patients in each group. Hypospadias repair was performed in all patients and outcome was assessed immediate, 1month, 3month, and 6 months. post op complications were categorised as early and late. Result- Most common age group at which children were operated were 1-3 age group. Cure rate of hypospadias surgery in our study was 79% and fistula rate was 21%.Most common type of hypospadias observed was sub-coronal.Other complications were pain, fever, haematuria,wound dehiscence, flap necrosis, blockage was found in clinically non-significant level. The rate of fistula was 26% in buck’s fascia group and 16% in dartos group. P-value (0.216) for fistula rate in both groups is non-significant yet it can consider a clinically significant difference. Conclusion:- We recommended to use of dartos fascia as vascularised intermediate layer to reinforce urethral suture line in hypospadias surgery. we see in buck’s fascia as reinforcement is not good. this can be due to its difficult separation from its bed and thin and less vascular in distal areas of penis. Keywords: Dartos flap, fistula, hypospadias, intermediate layer, spongiosum --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 17-10-2019 Date of Acceptance: 02-11-2019 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Hypospadias corrective surgery is challenging surgery in respect of complication and cosmetic correction. Despite the development of a number of techniquesfor hypospadias surgery, fistula and glans dehiscenceare potential pitfall. After urethral repair A vascularised flap was placed above the suture line to reinforce it and prevent further complication. We describe a use of buck’s fascia and dartos fascia as intermediate layer to reinforce urethral suture line in hypospadias surgery. II. Materials and Methods This study done from December 2017 and march 2019, at MGMMC AND M.Y.HOSPITAL INDORE. Total 100 patients of1year to 14year age were studied which were divided in two study groups bucks fascia and dartos fascia group with 50 patients in each group in random distributionfashion. Surgery were done according to anatomical requirement.Most of the patient were undergone snodgrass urethroplasty and outcome was assessed on immediate, 1month, 3month, and 6 months period. post op complications were categorised as early and late. Data was collected and master chart was prepared. Data was analysed statistically and clinically.