Modified PATIO repair for urethrocutaneous fistula post-hypospadias repair: operative technique and outcomes.

Abstract

To describe a modification of PATIO repair for urethrocutaneous fistula repair and evaluate its outcome. 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. Mean age of the studied patients was 67.6months (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 43.4months (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 47.2min (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. Modified PATIO method is technically easy method for urethrocutaneous fistula repair, with less operating time and good postoperative outcomes.