Dermal regeneration sheet Integra® in management of recurrent Urethrocutaneous fistula after hypospadias surgery

PURPOSE: Urethrocutaneous fistula and neourethral dehiscence are frequently seen complications of hypospadias surgery requiring reoperation. In this study we report the experience of one surgeon with dartos flap coverage in primary hypospadias, reoperative hypospadias and urethrocutaneous fistulas repair. METHODS: A total of 23 patients underwent hypospadias and urethrocutaneous fistulas repair from January 2006 to May 2009. Fourteen patients were operated on for primary hypospadias repair at our institution and 9 patients were admitted for hypospadias complications such as failed hypospadias repair and urethrocutaneous fistula. In all the patients, the dartos flap was dissected and transposed to cover the neourethra. Operative results were recorded. RESULTS: The primary surgical procedure was a one-stage repair in 61% (n = 14); tubularised incised plate (TIP) urethroplasty in 43% (n = 6) and a Mathieu procedure in 57% (n = 8). Urethrocutaneous fistulas complicating the previous initial hypospadias repair were anterior in 33% (n = 2), middle in 33% (n = 2) and proximal in 33% (n = 2). Repair of the fistula was successful on the first attempt in all patients. The reason for redo surgery in 3 patients was complete dehiscence and the patients had distal shaft hypospadias. CONCLUSION: Dartos flap coverage of the neourethra seems to be an effective method of reducing the fistulous complication rate following primary and secondary hypospadias repair.

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Ointment Fistulography: Introducing a Novel Technique for Single or Multiple Urethrocutaneous Fistula Diagnosis After Hypospadias Surgery

Urology ◽

10.1016/j.urology.2017.03.037 ◽

2017 ◽

Vol 106 ◽

pp. 231-232

Author(s):

Sarah Mozafarpour ◽

Abdol-Mohammad Kajbafzadeh ◽

Reza Abbasioun ◽

Ali Akbar Habibi ◽

Behnam Nabavizadeh

Keyword(s):

Urethrocutaneous Fistula ◽

Novel Technique ◽

Hypospadias Surgery

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Urethroplasty by midline longitudinal incision of the dorsal wall of urethra at the site of the fistula: A useful adjunct to the conventional method of repair of urethrocutaneous fistula developing after hypospadias surgery

Journal of Indian Association of Pediatric Surgeons ◽

10.4103/0971-9261.24633 ◽

2006 ◽

Vol 11 (1) ◽

pp. 24

Author(s):

Ruchirendu Sarkar ◽

H Konar ◽

K Sahabasu ◽

K Saha ◽

N Samanta

Keyword(s):

Conventional Method ◽

Urethrocutaneous Fistula ◽

Dorsal Wall ◽

Longitudinal Incision ◽

Hypospadias Surgery

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OUTCOME OF TUNICA VAGINALIS FLAP FOR REPAIR OF URETHROCUTANEOUS FISTULA AFTER HYPOSPADIAS REPAIR

10.36106/gjra/5205428 ◽

2021 ◽

pp. 27-28

Author(s):

Aniket Patil ◽

Ajay Naik

Keyword(s):

Suture Material ◽

Surgical Techniques ◽

Absorbable Suture ◽

Hypospadias Repair ◽

Urethrocutaneous Fistula ◽

Tunica Vaginalis ◽

Basic Principles ◽

Urethral Closure ◽

Distal Obstruction ◽

Hypospadias Surgery

The commonest complication following hypospadias repair is occurrence of urethro-cutaneous stula(UCF) with a reported incidence of 4-25% 1. The expected stula rate is between 10% to 15% for onestage hypospadias surgery. UCF after hypospadias repair remains a signicant challenge for paediatric surgeons despite the advances in surgical techniques. Our aim is to assess the outcome of tunica vaginalis ap repair in cases of urethro-cutaneous stula. Our study included 23 patients who underwent UCF repair using TVF. Successful repair of these UCF depends on several basic principles, which are the avoidance of procedures on inamed tissue, correction of distal obstruction, a tension-free urethral closure with absorbable suture material, and covering of the urethral repair with well-vascularized tissue. From our study we feel that many complications mainly recurrent stula can be avoided using the above principles.

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