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INDONESIA
Indonesian Journal of Urology
Published by Universitas Airlangga
ISSN : 0853442X     EISSN : 23551402     DOI : 10.32421
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
The aim of Indonesian Journal of Urology is to encompass the whole spectrum of urology. The journal publishes papers on a wide range of urological issues such as oncology, functional urology, reconstructive urology, laparoscopy, robotic surgery, endourology, female urology, andrology, pediatric urology, and sexual medicine. We welcome authors for original article (research), review article, interesting case reports, special article, clinical practices, and medical illustrations that focus on the clinical area of urology.
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Articles 511 Documents
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DARTOS FASCIA AS AN INTERPOSITIONAL LAYER IN HYPOSPADIAS URETHROPLASTY: A SYSTEMATIC REVIEW Marta Hendry; Krisna Murti; Besut Daryanto; Iche Andriyani Liberty
Indonesian Journal of Urology Vol 33 No 2 (2026)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v33i2.1142

Abstract

Introduction: Hypospadias is a common congenital anomaly of the male genitalia (1 in 300 births), characterized by a ventrally displaced meatus, often with chordee and a dorsal hooded prepuce. Objective: This systematic review evaluated the role of dartos fascia as an interpositional layer in primary hypospadias repair. Material & methods: Search was conducted in PubMed, EMBASE, Scopus, CENTRAL, and Web of Science (2019–2025) for studies in patients ≤18 years undergoing hypospadias repair. Primary outcomes were urethrocutaneous fistula (UCF), dehiscence, meatal/urethral stenosis, and reoperation; secondary outcomes were infection and cosmetic scores. Narrative synthesis was used. Results: Eleven studies met criteria, predominantly distal TIP. No randomized trial compared any second layer versus none; one cohort (n=425) showed similar UCF with periurethral/dartos coverage versus none (6.7% vs 7.3%). A randomized trial favored double- over single-layer dartos (3.3% vs 23.3%). Another trial found ventral preferable to dorsal dartos with fewer flap-related complications at similar UCF rates. Tunica vaginalis flap reduced UCF and improved cosmetics but is more invasive. Platelet-rich fibrin adjunct lowered UCF and infection in two studies. Spongioplasty produced comparable UCF but higher meatal stenosis, though selected robust spongiosum allowed zero fistulas. Conclusion: Dartos remains the workhorse; double-layer and ventral harvest optimize outcomes, while tunica vaginalis and PRF offer effective alternatives in selected cases. Further randomized trials are needed to clarify the necessity of a second layer. Keywords: Hypospadias, urethroplasty, dartos fascia, urethrocutaneous fistula, tunica vaginalis flap.

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