ABSTRACT
OBJECTIVE: To describe a simple and effective technique for repairing a small-diameter urethrocutaneous fistula. METHODS AND TECHNIQUE: A total of 13 patients with a solitary and small-diameter (≤2 mm) urethrocutaneous fistula underwent repair with a ligation technique. RESULTS: None of the patients had voiding difficulties. One recurrent urethrocutaneous fistula occurred and it was successfully repaired with the same technique. CONCLUSION: This is a simple, quick and useful technique, particularly for small-diameter (≤2 mm) urethrocutaneous fistulas.
Subject(s)
Cutaneous Fistula/surgery , Plastic Surgery Procedures/methods , Surgical Flaps , Urinary Fistula/surgery , Urologic Surgical Procedures, Male/methods , Adolescent , Child , Child, Preschool , Humans , Male , Treatment Outcome , Urodynamics/physiologyABSTRACT
OBJECTIVE: Congenital anterior urethrocutaneous fistula, is a rare anomaly characterised by fistulisation of penile urethra to skin and presence of a concomitant normal or hypospadiac external urethral meatus. It may be seen as an isolated anomaly or may accompany genitourinary or anorectal malformations. We aim to present 3 new cases and define the common properties of patients stated in literature. Methos: Information of 3 patients aged 2, 3 and 6 with this diagnosis were reviewed retrospectively and features of 51 patients in 25 articles with literature search. RESULTS: From the patients we operated, 2 had midpenile and 1 had subcoronal fistula. Urethral meatus was at tip of glans in all with 1 stenotic meatus. Two-layered primary repair was performed in 3 patients and deep ventral incision on urethral plate with meatotomy were added to fistula repair in one with stenotic meatus. Fistula recurred in this patient but resolved spontaneously after dilatations. In literature, most common fistula site was subcoronal in 27 (52.9%). Hypospadias was in 11.8% and associated genitourinary anomaly was detected in 21.5% of patients. Fistula recurrence ratio was 7.8% using different surgical techniques. CONCLUSION: Congenital anterior urethrocutaneous fistula is frequently located in subcoronal level and usually a normal urethra distal to it. Physical examination is important to detect additional anomalies. Success rates are high with primary repair techniques
OBJETIVO: La fistula uretrocutánea anterior congénita es una rara anomalía caracterizada por la fistulización de la uretra peneana a piel y la presencia concomitante de un meato uretral externo normal o hipospádico. Se puede presentar como una anomalía aislada o puede acompañar a otras malformaciones genitourinarias y anorrectales. Presentamos 3 nuevos casos y definimos las propiedades comunes establecidas en la literatura. MÉTODOS: Se revisó retrospectivamente la información de 3 pacientes de 2, 3 y 6 años de edad con este diagnóstico y las características de 51 pacientes de 25 artículos publicados. RESULTADOS: De los pacientes que operamos, 2 tenían la fístula en pene medio y 1 subcoronal. El meato uretral se localizaba en la punta del glande en todos ellos, con un meato estenótico en 1 caso. Se realizó reparación primaria en 2 capas en los 3 pacientes, con la adición de una incisión ventral profunda de la placa uretral y meatotomía en el caso con estenosis meatal. La fistula recurrió en este último caso pero se resolvió espontáneamente con dilataciones. En la literatura el sitio más frecuente de fístula es subcoronal en 27 (52,9%). Había hipospadias en 11,8% de los pacientes y se detectaron anomalías genitourinarias asociadas en el 21,5%. La tasa de recurrencia de la fistula fue del 7,8% utilizando diferentes técnicas quirúrgicas. CONCLUSIONS: La fístula uretrocutánea anterior congénita se localiza frecuentemente en el nivel subcoronal y generalmente la uretra distal es normal. La exploración física es importante para detectar anomalías adicionales. Con las técnicas de reparación primaria las tasas de éxito son altas