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A simple procedure for management of urethrocutaneous fistulas; post-hypospadias repair


S Mohamed
N Mohamed
T Esmael
S Khaled

Abstract

Objectives: The treatment of urethral fistulas is quite challenging. We try to evaluate the results of a simple procedure in post-hypospadias urethral fistula repair.
Materials and Methods: In the period from 2003 to 2007, 35 patients with 35 fistulas, with an average age 3.5 years [range: 2-8], were classified into coronal 12, mid-penile 13 and proximal 10. Based on the size they
were grouped into two - either less than 5 mm (20) or more than 5 mm (15). Midline relaxing incision was used for large fistulas and then covered with a vascularised flap dartos-based flap [flip flap] in 19 and tunica vaginalis in
16. If a patient had more than one small fistula adjacent to each other, they were joined into a large single fistula and then repaired.

Results: We have successfully repaired all urethrocutaneous fistulas using our protocol, with success rate [97.3] 1/35.

Conclusions: Dorsal midline urethral incision (DUMI), with dartos flip flap or tunica vaginalis coverage is an appropriate procedure to repair midline and proximal urethral fistulas.


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eISSN: 0189-6725