Abstract
Background
To describe a modification of PATIO repair for urethrocutaneous fistula repair and evaluate its outcome.
Methods
We studied 15 boys who underwent modified PATIO repair from Jan 2010 to Sept 2015. Parameters studied included age, type of hypospadias, age at first urethroplasty, hypospadias repair technique, number of urethroplasties required, location of fistula, time gap between urethroplasty and fistula repair, method of fistula repair, and outcome of fistula repair.
Results
Mean age of the studied patients was 67.6 months (38–139). Type of hypospadias was Coronal = 3, subcoronal = 8, mid-penile = 2, prominal penile = 1, and penoscrotal = 1. Ten patients had single urethroplasty, while two patients had two urethroplasties, details not available for three patients. Average age at urethroplasty was 43.4 months (18–110). 12 patients had Snodgrass repair, Mathieu = 1 patient, tubularised plate repair = 1 patient, and unknown = 1 patient. Location of fistula was coronal in nine patients and subcoronal in six patients. Average operative time was 47.2 min (30–68). Follow-up is available for 12 patients out of which 2 patients had recurrent fistula, one of which was successfully treated by the redo modified PATIO method.
Conclusion
Modified PATIO method is technically easy method for urethrocutaneous fistula repair, with less operating time and good postoperative outcomes.
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References
Caione P (2009) Prevalence of hypospadias in european countries: is it increasing? Eur Urol 55(5):1027–1029
Holland AJ, Abubacker M, Smith GH, Cass DT (2008) Management of urethrocutaneous fistula following hypospadias repair. Pediatr Surg Int 24(9):1047–1051
Cimador M, Castagnetti M, De Grazia E (2003) Urethrocutaneous fistula repair after hypospadias surgery. BJU Int 92:621–623
Malone PR (2009) Urethrocutaneous fistula: preserve the tract and turn it inside out: the PATIO repair. BJU Int 104(4):550–554
Nassar N, Bower C, Barker A (2007) Increasing prevalence of hypospadias in Western Australia, 1980–2000. Arch of Dis in Child. 92(7):580–584
Chung J-W, Choi SH, Kim BS, Chung SK (2012) Risk factors for the development of urethrocutaneous fistula after hypospadias repair: a retrospective study. Korean J Urol 53(10):711–715
Richter F, Pinto PA, Stock JA, Hanna MK (2003) Management of recurrent urethral fistulas after hypospadias repair. Urology 61:448–451
Mohamed S, Mohamed N, Esmael T, Khaled S (2010) A simple procedure for management of urethrocutaneous fistulas; post-hypospadias repair. Afr J Paediatr Surg 7:124–128
Srivastava RK, Tandale MS, Panse N, Gupta A, Sahane P (2011) Management of urethrocutaneous fistula after hypospadias surgery—an experience of thirty-five cases. Ind J Plast Surg 44(1):98–103
Yassin T, Bahaaeldin KH, Husein A, Minawi HE (2013) Assessment and management of urethrocutaneous fistula developing after hypospadias repair. Ann Pediatr Surg 7(2):88–93
Nerli RB, Metgud T, Bindu S, Guntaka A, Patil S, Neelgund SE, Hiremath MB (2011) Solitary urethrocutaneous fistula managed by the PATIO repair. J Pediatr Urol 7(2):166–169
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Rathod, K., Loyal, J., More, B. et al. Modified PATIO repair for urethrocutaneous fistula post-hypospadias repair: operative technique and outcomes. Pediatr Surg Int 33, 109–112 (2017). https://doi.org/10.1007/s00383-016-3983-1
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DOI: https://doi.org/10.1007/s00383-016-3983-1