MANAGEMENT OF URETHROCUTANEOUS FISTULA FOLLOWING HYPOSPADIAS REPAIR, COMPARATIVE STUDY BETWEEN SIMPLE CLOSURE VERSUS FLAP TECHNIQUE

Abstract

U rethrocutaneous fistula is the most common complication after hypospadias repair. Furthermore, with the improvement in suture materials and surgical techniques, such complications are increasingly unacceptable. Several techniques have been described for fistula repair after hypospadias surgery but it remains a disappointing problem to the patient and the surgeon. The size of the fistula and status of the surrounding skin usually determine the optimum technique for repairing a urethrocutaneous fistula. Simple closure is technically easy and not time consuming, but overlying suture lines are a potential risk for recurrence. Skin flaps are used for repairing fistulae that are too large for simple closure, provided that the local skin is pliable and adequate. We performed our study during the period from June 2012 through October 2013. We conducted a prospective study aiming to compare different forms of repair of urethrocutaneous fistula after hypospadias surgery. We enrolled 30 patients in our study. Their age ranged from 1.5 to 14 years. Of the 30 candidates, 22 (73%) suffered from distal penile fistula, 2 (6.6%) were coronal, 3 (10%) were mid penile, 1 (3.3%) penoscrotal and 2 (6.6%) were proximal penile fistula. The cases were evenly distributed into 2 groups (15 each). The first group was managed by simple closure of the fistula and the second group was managed by skin flap closure. The distribution into these groups was random.