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

Abstract

The treatment of urethral fistulas is quite challenging. We try to evaluate the results of a simple procedure in post-hypospadias urethral fistula repair. 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. We have successfully repaired all urethrocutaneous fistulas using our protocol, with success rate [97.3] 1/35. Dorsal midline urethral incision (DUMI), with dartos flip flap or tunica vaginalis coverage is an appropriate procedure to repair midline and proximal urethral fistulas.