Pediatric Surgery International

, Volume 26, Issue 3, pp 305–308 | Cite as

Urethrocutaneous fistula after hypospadias repair: outcome of three types of closure techniques

  • Kaliyaperumal Muruganandham
  • M. S. Ansari
  • Deepak Dubey
  • Anil Mandhani
  • Aneesh Srivastava
  • Rakesh Kapoor
  • Anant Kumar
Original Article
First Online:
Accepted:

Abstract

Objective

To evaluate the outcomes of three surgical techniques for the closure of urethrocutaneous fistula (UCF) after hypospadias repair.

Materials and methods

Fifty-one patients (mean age 6.5 years) who underwent UCF closure between June 1998 and February 2008 were divided in to three groups depending on fistula size; group I had <2 mm and (n = 17, 33.4%), group II had 2–4 mm (n = 21, 41.2%) and group III had >4 mm or multiple fistulas (n = 13, 25.4%). Group I patients were treated by excision and simple closure. Patients in group II and III were treated with flip flap technique along with the wrapping of repaired area with scrotal dartos flap and tunneled tunica vaginalis flap (TVF), respectively.

Results

Mean surgical time was 45 min (range 30–55), 60 min (range 50–75) and 80 min (range 60–100) in three techniques, respectively. The mean follow-up was 3.5 years (range 6 months–10 years). No patient had recurrence of fistula in group III, while 2 (9.5%) and 4 (25.4%) patients in groups II and I, respectively, had recurrent UCF. No postoperative complications were encountered in the testis or the scrotum. No patient had torsion or deviation of penis.

Conclusion

Simple fistula closure carries a higher risk of recurrence even in small sized fistulas. The application of scrotal dartos or TVF for wrapping the repaired area gives excellent results and they are easy to harvest with no harmful effects on the scrotum or testis.

Keywords

Hypospadias Urethral Stricture Fistulous Tract Fistula Repair Urethral Diverticulum 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Kaliyaperumal Muruganandham
    • 1
  • M. S. Ansari
    • 1
  • Deepak Dubey
    • 1
  • Anil Mandhani
    • 1
  • Aneesh Srivastava
    • 1
  • Rakesh Kapoor
    • 1
  • Anant Kumar
    • 1
  1. 1.Department of Urology SGPGIMSLucknowIndia

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