Management of Post Hypospadias Urethral Fistula

Shehata, Sherif; Hashish, Mohamed S.

doi:10.5772/22653

Cited by 10 publications

(17 citation statements)

References 34 publications

(53 reference statements)

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“…In cases with multiple fistulas adjacent to each other, all are joined and made into single fistula. Single staged operation is still valid for multiple fistulas adjacent to each other [1,4] . Durham Smith vest-over-pant repair using de-epithelialized skin flap is done in all cases as described by Durham Smith [5] .…”

Section: Discussionmentioning

confidence: 99%

“…Under general anesthesia site, size, number of fistulas, and status of the surrounding skin can be meticulously examined and distal obstruction ruled out by inserting feeding tube in all cases [1] . Distal obstruction must be ruled out by cystoscopy, retrograde urethrography, or urethral calibration.…”

Section: Discussionmentioning

confidence: 99%

“…A catheter or feeding tube one size smaller than urethral lumen should be selected to permit voiding around the tube if tube becomes blocked or bladder spasm occurs. The different water-proofing layers used in various series were de-epithelialized skin, tunica vaginalis, dartos flap, dorsal subcutaneous preputial flap, and external spermatic fascia [1] . Time period of feeding tube/ catheter is variable in various series from 4 to 10 days [2,4] .…”

Section: Discussionmentioning

confidence: 99%

“…Durham Smith vest-over-pant repair using de-epithelialized skin flap is done in all cases as described by Durham Smith [5] . Urethra should be closed over feeding tube of size 6/8 Fr as per the caliber of urethra, using 6-0 Vicryl in continuous fashion by inverting the edges of urethra [1,4,6] . A catheter or feeding tube one size smaller than urethral lumen should be selected to permit voiding around the tube if tube becomes blocked or bladder spasm occurs.…”

Section: Discussionmentioning

confidence: 99%

“…Urethrocutaneous fistula, which occurs after hypospadias surgery, is the most common complication and remains a challenging problem for surgeons [1] . Unfortunately, there is no single perfect technique to repair all types of fistulas [2] .…”

Section: Introductionmentioning

confidence: 99%

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Durham Smith Vest-Over-Pant Technique: Simple Procedure for a Complex Problem (Post-Hypospadias Repair Fistula)

et al. 2017

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Durham Smith Vest-Over-Pant Technique: Simple Procedure for a Complex Problem (Post-Hypospadias Repair Fistula)

et al. 2017

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Risk Factors of Urethro-cutaneous Fistula Development in Hypospadias Surgery

Permana

Tarmono²,

Renaldo³

2021

JKB

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<p align="justify">Urethrocutaneous fistula development is the most common complication found hypospadias surgery. Several factors associated with the incidence of fistulas are the age at the time the surgery. The type of hypospadias, the degree of chordae, the operative technique applied and catheter type. This study aimed to determine the risk factors associated with the urethro-cutaneous fistula development in hypospadias surgery. The results showed that from 310 hypospadias patients undergoing urethroplasty, urethra cutaneous fistula development occurred among 105 patients (30.6%) with a mean age of surgery 10.89+6.27 years. Hypospadias type has a significant difference with the incidence of urethro-cutaneous fistula development (p = 0.027). Age (p = 0.615), degree of chordae (P=0.805), operative technique (P=0.901) and catheter type (P=691) do not have a significant impact to urethro-cutaneous fistula development. It can be concluded that operative urethroplasty has a risk of urethra-cutaneous fistula that associated with hypospadias type.</p>

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Outcome of buccal mucosal patch graft in the Management of recurrent hypospadias urethrocutaneous fistula

Jasim

2015

JFacMedBagdad

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Background: urethrocutaneous fistula after hypospadias surgery repair is the most common complication and remains a frustrating problem for surgeon and the patient. The problem is exacerbated because the urethrocutaneous fistula may recur which adds more demands surgery.Objectives: The purpose of this study is to evaluate of the use of oral mucosal graft for management of recurrent urethrocutaneous fistula after hypospadias repair.Patients and Methods: twelfth patients with age ranging from 4 year to 15 years were presented with history of recurrent fistula. Most of fistula were located in proximal penile and penoscrotal region (58.3%) . those patients were repaired by using oral mucosal graft with mean postoperative follow up period up to 6 months.Results: analysis of results showed 10 out of 12 cases (83.3%) had a final successful outcome with no recurrent fistula during follow up period. The two patients with failed repair were candidate for another attempt for fistula repair later on. No donor site morbidity was observed in all patients.Conclusion: Oral mucosal graft showed very good take and promising results when used for management of recurrent urethrocutaneous fistula after hypospadias repair.

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Management of Post Hypospadias Urethral Fistula

Cited by 10 publications

References 34 publications

Durham Smith Vest-Over-Pant Technique: Simple Procedure for a Complex Problem (Post-Hypospadias Repair Fistula)

Durham Smith Vest-Over-Pant Technique: Simple Procedure for a Complex Problem (Post-Hypospadias Repair Fistula)

Risk Factors of Urethro-cutaneous Fistula Development in Hypospadias Surgery

Outcome of buccal mucosal patch graft in the Management of recurrent hypospadias urethrocutaneous fistula

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