The management of testicular rupture in children with a large tunical defect is challenging. We describe a technique suitable when primary closure cannot be achieved. A 16-year-old boy presented with right testicular rupture. Owing to the large tunical separation and excessive edema, primary closure could not be achieved. A tunica vaginalis flap was then fashioned with a broad-based pedicle to complete closure. The patient had an uneventful recovery. At 4 months postoperatively, the testis was of normal size and position, and the ultrasound findings were normal. The vascularized tunica vaginalis flap provides an excellent alternative method for closure of pediatric testicular rupture.
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