Tubularized incised plate urethroplasty for the treatment of penile fistulas after hypospadias repair

Tubularized incised plate urethroplasty for the treatment of penile fistulas after hypospadias repair

Abstract Objective Urethrocutaneous fistula is the most common complication of hypospadias repair. Tubularized incised plate urethroplasty (TIPU) has been used for the management of distal fistulas. This study reports the usage of TIPU in the treatment of large penile fistulas. Materials and methods...

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Bibliographic Details
Published in:Journal of pediatric urology Vol. 10; no. 3; pp. 455 - 458
Main Authors: Karakuş, O.Z, Ateş, O, Tekin, A, Hakgüder, G, Olguner, M, Akgür, F.M
Format: Journal Article
Language:English
Published: England Elsevier Ltd 01-06-2014
Subjects:
Adolescent
Child
Child, Preschool
Fistula - etiology
Fistula - surgery
Follow-Up Studies
Humans
Hypospadias - surgery
Hypospadias repair
Infant
Male
Pediatrics
Penile Diseases - etiology
Penile Diseases - surgery
Penile fistula
Penis - surgery
Postoperative Complications - etiology
Postoperative Complications - surgery
Recurrence
Retrospective Studies
Surgical Flaps
Treatment Outcome
Tubularized plate incised urethroplasty
Urethral fistula
Urologic Surgical Procedures, Male - methods
Urology
Tubularized plate incised urethroplasty
Penile fistula
Urethral fistula
Hypospadias repair
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Summary:Abstract Objective Urethrocutaneous fistula is the most common complication of hypospadias repair. Tubularized incised plate urethroplasty (TIPU) has been used for the management of distal fistulas. This study reports the usage of TIPU in the treatment of large penile fistulas. Materials and methods Between April 2002 and September 2012, 15 patients with large penile fistulas who were managed with TIPU were included in the study. The fistulas were sited along the penile shaft from proximal to distal penile localization. Glanular and coronal fistulas were excluded. The surgical technique was completed according to the standard TIPU technique. The surrounding scar tissue of the fistula was circumferentially excised, and the urethral plate at the level of the fistula was incised to provide performance of loose urethral tubularization. A urethral stent was kept for 5–7 days. Results The mean age of the patients was 7.3 ± 3.1 years. Primary operation of these patients was tubularized preputial island flap ( n  = 6), on-lay preputial island flap ( n  = 4), and TIPU ( n  = 5). The sites of the hypospadias fistulas were as follows; penoscrotal (three), mid-penile (eight) and subcoronal (four). Fistulas recurred in two patients after fistula repair. The postoperative follow up of the patients was 12.4 ± 7.7 months. Conclusion TIPU may be used safely for the treatment of fistulas after hypospadias repair.
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ISSN:1477-5131
1873-4898
DOI:10.1016/j.jpurol.2013.10.020