Urethro-cutaneous fistula after hypospadia repair: a single institution study

Tim Jumbi,Joel Lessan,Peter Mwika,Robert Mugo,Swaleh Shahbal,Francis Osawa

doi:10.4314/aas.v16i2.4

Abstract

Urethro-cutaneous fistula (UCF) is one of the most frequently seen complications of hypospadias surgery requiring reoperation; it occurs with an incidence of between 4% and 28%. Risk factors associated with the development of UCF can be classified as preoperative, intraoperative or postoperative. The aim of this study was to determine the association of perioperative risk factors and the development of urethrocutaneous fistula after hypospadias repair. A retrospective review of patients who had undergone hypospadias repair at Kenyatta National Hospital between 2013 and 2017 was conducted. 114 patient records were retrieved. The incidence of UCF was 47%. Risk factors that were significantly associated with UCF are hypospadias type (p=0.028), lack of a protective intermediate layer (p=0.002), and presence of postoperative complications (p=0.001). Age at surgery, suture material, type of repair and use of catheter/stents were not significant factors. Multivariate analysis showed wound infection and meatal stenosis as the most significant factors associated with UCF development.Keywords: Hypospadias, Urethro-cutaneous fistula, Risk factors, Wound infection, Meatal stenosis

Highlights

Urethro-cutaneous fistula (UCF) is one of the most frequently seen complications of hypospadias surgery [1].Incidence is variable but is commonly reported between 4% and 28% [2]
Usually from the third day of surgery, contributes a reduce the rate of wound infection after hypospadias surgery dual effect of reducing infection and moisturizing the site. and surgical technique aimed at reducing the rate of meatal
These measures have been strengthened in the 5-year period, the decrease in infection rate which in this study was directly proportional to the incidence of fistula formation

Summary

Introduction

Urethro-cutaneous fistula (UCF) is one of the most frequently seen complications of hypospadias surgery [1].Incidence is variable but is commonly reported between 4% and 28% [2]. Breaking down the surgical technique into measurable components allows for statistical analysis. Such components include type of repair, tissue handling, use of vascularized tissue layers, and type and size of suture material [1, 2, 7].Fistula formation is multifactorial and the risk factors for fistula development vary. The purpose of this study was to determine the association of peri-operative risk factors with the development of urethro-cutaneous fistula after hypospadias repair

Objectives

Methods

Results

Discussion

Conclusion