A simple procedure for management of urethrocutaneous fistula after hypospadias repair

Abstract

Objective The treatment of urethral fistula is quite challenging. We tried to evaluate the results of a simple procedure in urethral fistula repair. Background A urethrocutaneous fistula is a common complication of urethroplasty. These fistulae may be caused by a variety of factors and occur in different sizes at various sites of the previous repair. Materials and methods A variety of methods have been described in the literature for the repair of urethrocutaneous fistulae with variable results. In this study of 25 cases, we have successfully repaired urethrocutaneous fistulae using perifistula non-hair-bearing penile skin flaps for their closure in the period spanning from January 2005 to December 2015. The operation consists of the creation of perifistula non-hair-bearing penile skin-based flap after marking the site. It was created with one side being kept large as compared with the other side in any direction. We mobilized the flap and the larger sized flap was folded over the tube just like a hat of a box and sutured it with the other side of the flap. We did it in only midpenile and proximal fistulas, irrespective of the size of the fistulas, whether they were small, medium or large sized. We included recurrent as well as fistula after primary repair. Results The mean age of patients was 6 years. We have successfully repaired all urethrocutaneous fistulae using our protocol with a success rate of 100%. Conclusion Flap technique is an appropriate procedure for repair of midshaft and proximal urethral fistulae of any size.