Objective: Urethrocutaneous fistula, which occurs after hypospadias surgery, is often a baffling problem and its treatment is challenging. The study aimed to evaluate the results of the simple procedure (Durham Smith vest-over-pant technique) for this complex problem (post-hypospadias repair fistula). Methods: During the period from 2011 to 2015, 20 patients with post-hypospadias repair fistulas underwent Durham Smith repair. Common age group was between 5 and 12 years. Site wise distribution of fistula was coronal 2 (10%), distal penile 7 (35%), mid-penile 7 (35%), and proximal-penile 4 (20%). Out of 20 patients, 15 had fistula of size <5 mm (75%) and 5 patients had fistula of size >5 mm (25%). All cases were repaired with Durham Smith vest-over-pant technique by a single surgeon. In case of multiple fistulas adjacent to each other, all fistulas were joined to form single fistula and repaired. Results: We have successfully repaired all post-hypospadias surgery urethrocutaneous fistulas using the technique described by Durham Smith with 100% success rate. Conclusion: Durham Smith vest-over-pant technique is a simple solution for a complex problem (post hypospadias surgery penile fistulas) in properly selected patients.

Aim: Aim of our study is to demonstrate that modified O'Connor's technique is possible and feasible for all types of postobstetric and gynecological procedures vesicovaginal fistula (VVF). Materials and methods:The study of 38 patients includes 34 primary and four recurrent (operated primarily elsewhere) type of VVF treated by modified O'Connor technique with omental flap interposition between January 2009 to June 2016 by a single surgeon. Patients were followed postoperatively at 3 weeks, 3 monthly for 6 months and later depending on symptoms.Results: Common age group in our study between 30 years and 40 years (50%). Twenty-eight patients had simple fistula while 10 had a complex fistula. Fistula size ranges from 5 mm to 4 cm with the most common size ranges between 1 cm and 3 cm (28 patients). Thirty-three patients had a single fistula and 5 had two fistulae includes one patient of asymptomatic vesicoperitoneal fistula. The most common cause of fistula was posthysterectomy, for benign diseases (25 cases). the most common site was supratrigonal (28 cases) and in 10 cases involving either trigone or infratrigonal area. All patients were dry following catheter removal. The success rate of the technique was 100%. There was no perioperative complication except one patient had mild stress urinary incontinence (SUI), one had recurrent urinary tract infection and three had storage lower urinary tract symptoms (LUTS). Conclusion:Modified O'Connor repair is safe and gives excellent functional results in postobstetrics and gynecological procedures related to VVF. Selection of technique should depend on experience and preference of surgeon which gives maximum success rate.