Cyanoacrylate Based Products as Interpositioning Substance versus Reintervention Alone for Urethrocutaneous Fistula Repair after Hypospadias

Abstract

Abstract Background urethrocutaneous fistula (UCF) is still the commonest complication after hypospadias repair. Although recent advances in the surgical procedures of hypospadias repair have reduced the rate of urethrocutaneous fistula formation, it remains a real complication of hypospadias and frustrating problem for surgeons. Aim of the Work evaluation of success and failure rates of using cyanoacrylate based productes as an interpositioning substance in surgical repair of fistula after hypospadias in comparison to the classic surgical repair technique. Patients and Methods this is a prospective, randomized-controled study, conducted on 40 patients from the date of the approval of the study. It is comparing two different modalities for repair of urethrocutaneous fistula that has developed after hypospadias repair. Our study was assigned on a randomized basis method according to a 1:1 ratio and patients underwent either multilayered closure using dartos facial flap or using cyanoacrylate glue as an interpositioning layer before suturing of the dartos flap for the closure of the urethrocutaneous fistula. All cases were divided into 2 equal groups, 20 cases each. The cases were distributed randomly into the two groups. Results the success rate was higher for patients using cyanoacrylate glue as a protective interpositioning layer as 16 patients (80%) were successfully repaired and 4 patients (20%) developed a recurrent fistula. However, there was no statistically significant difference between 2 groups p-value was 0.465. Conclusion there was no statistically significant difference in adding cyanoacrylate glue to multilayered closure of urethrocutaneous fistula after hypospadias repair. However, cyanoacrylates showed that they are a favourable additional protective substance and they resulted in a high success rate without adding any surgical complications.