Tunica vaginalis testis (pars parietal) is another tissue donor site that has the capability of being used both as flap and free graft.

In clinical practice, it has usually been used as a second layer for augmentation in a tabularized incision plate (TIP) in order to prevent subsequent urethrocutaneous fistula formation.[5] Also it has been used for correction of penile cuvature (chordee)[6] and surgical treatment of Peyronie’s disease.[7] Many experimental studies[8-12] and a few clinical studies[13, 14] have reported the feasibility and usefulness of using tunica vaginalis for definitive urethroplasty in anterior urethral strictures. The majority of those experimental studies find more have revealed that tunica vaginalis mesothelium was gradually replaced by a more stratified epithelial lining similar to the urethral lining of the native urethra. In the current study, we retrospectively evaluated the clinical efficacy and feasibility of tunica vaginalis (TV) pedicle flap for reconstruction of anterior urethral stricture by comparing some clinical

parameters including the urinary flow rate (Qmax), international prostate symptom score (IPSS), patients quality of life (QoL) and residual urine (RU). The pre-operative result was compared 3 and 12 months postoperatively. Obeticholic Acid After obtaining institutional ethical review board approval, 15 male patients who had undergone Tunica vaginalis pedicle flap urethroplasty between January 2006 and January 2011, were retrospectively assessed. The procedure was allocated for patients who had not enough penile skin, including those who had previous

failed attempts of urethroplasty and those who had already underwent circumcision. Before surgery, the length of stricture was determined according to radiology reports and conventional retrograde urethrography plus voiding cystourethrography. During surgery, it was measured, using centimeter ruler. The urethroplasty had been done with two different techniques: TV pedicle flap ventral on lay urethroplasty (nine patients), and TV pedicle flap tubularized Lepirudin substitution urethroplasty (six patients). In order to assess the clinical efficacy and success rate of the surgical technique, the pre-operative Q(max), IPSS, QoL, RU were compared with them 3 and 12 months postoperatively. In order to know if there was change in caliber of urethra over time, the comparison was done between them at 3 and 12 months postoperatively. The t-test was used for statistical analysis. Moreover, pre-operative and postoperative retrograde urethrography was compared (Figs 1, 2). Van Buren urethral sounds (16–18 Fr) were used for checking and dilating the reconstructed part at 3 month intervals after surgery. Finally, Fisher’s exact test was used to find any difference between success rates of two aforementioned surgical techniques. Under epidural anesthesia the patient was placed in the lithotomy position.