A simple novel technique [PUIT] for closure of urethrocutaneous fistula after hypospadias repair: Preliminary results

ABSTRACTUrethrocutaneous fistula is a common complication of urethroplasty for severe hypospadias, even when a microsurgical technique is applied, the closure of the fistula is a challenging problem. We present a simple surgical procedure, posterior urethral incision technique [PUIT] to close the fistula in our department.Between February 2001 and December 2004 we prospectively evaluated 32 patients, 26 patients with initial hypospadias fistulas and 6 with recurrent fistulas who underwent closure of urethrocutaneous fistula after hypospadias repair. The mean age of patients was 5 years, the operation consisted of trimming the fistula edge after mobilization of the skin all-around then a midline posterior urethral incision was done 2 mm above and 2 mm below the fistula opening then re-approximation of the urethral edges using 6/0 vicryl sutures with loop magnification.The timing of fistula repair was between 6 and 13 months after it was formed, all of these were effectively closed except three cases with stricture and fistula. Of these, two were completely relieved after repeated urethral dilatation, three times a week for 2 weeks. The third failed case will need another sitting after 6 months.The posterior midline urethral incision gives a good opportunity for repair without tension with a good cosmetic outcome. This may be done under local anesthesia in adults. The procedure is considered simple rapid and easy to be done for variable fistulas types whatever of its site and the age.

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A Simple Method for Closure of Urethrocutaneous Fistula after Tubularized Incised Plate Repair: Preliminary Results

Nephro-Urology Monthly ◽

10.5812/numonthly.40371 ◽

2016 ◽

Vol 8 (6) ◽

Cited By ~ 3

Author(s):

Mehdi Shirazi ◽

Ali Ariafar ◽

Amir Hossein Babaei ◽

Abdosamad Ashrafzadeh ◽

Ali Adib

Keyword(s):

Urethrocutaneous Fistula ◽

Simple Method ◽

Preliminary Results ◽

Tubularized Incised Plate

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Snodgrass hypospadias repair with onlay overlapping double-layered dorsal dartos flap without urethrocutaneous fistula: Experience of 156 cases

Journal of Pediatric Urology ◽

10.1016/j.jpurol.2009.09.012 ◽

2010 ◽

Vol 6 (4) ◽

pp. 403-407 ◽

Cited By ~ 14

Author(s):

Ahmad Abolyosr

Keyword(s):

Hypospadias Repair ◽

Urethrocutaneous Fistula ◽

Dartos Flap

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Midshaft Hypospadias: Review of Surgical Technique

10.2310/uro.11047 ◽

2019 ◽

Author(s):

Erin R. McNamara ◽

Bryan Sack ◽

Alan B. Retik

Keyword(s):

Surgical Technique ◽

Key Words ◽

Common Type ◽

Hypospadias Repair ◽

Urethrocutaneous Fistula ◽

Tubularized Incised Plate ◽

Dartos Flap ◽

Tubularized Incised Plate Urethroplasty ◽

Skin Coverage

Surgical technique for midshaft hypospadias has evolved since the time of Horton and Devine. The most common type of repair that is currently used is the tubularized incised plate urethroplasty, which is a modification of the Thiersch-Duplay hypospadias repair. The authors review the steps of this procedure in detail and discuss troubleshooting for issues that may arise during the repair. Alternatives for chordee correction and skin coverage are reviewed. The authors briefly discuss outcomes and possible complications. In addition, there is a step-by-step video of a midshaft hypospadias repair that highlights the surgical technique. This review contains 9 figures, and 23 references. Key Words: chordee, dartos flap, hypospadias, midshaft hypospadias, surgical technique, tubularized incised plate (TIP), urethrocutaneous fistula, ventral curvature

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