Objective : To analyse the causes of fistulas following urethroplasty procedures and the principles of their surgical treatment. Material and Methods : 74 fistulas were treated : 6 were on the glans, 17 coronal, 33 on the distal shaft, 6 midshaft, 8 proximal shaft and 4 penoscotal. More than 75% underwent a simple closure or invagination of the fistula into the urethra, often without urinary diversion. A second-stage urethroplasty was necessary in 15 cases. Results : The initial success rate was 72,5%. Results obtained with simple closure or invagination were better than extensive surgery (50% failure rate). Seventy two percent of these fistulas without urinary diversion were treated successfully as compared to 53,8% of those which had required a catheter. Conclusion : Of all the complications of hypospadias surgery, fistulas are in most cases the easiest to resolve, provided that some fundamental rules are respected : a minimum of 6 month between both procedures, previous treatment of any concomitant urethral stenosis, use of a tourniquet and loops magnification, and an additional layer of interrupted subcutaneous sutures. A haemostatic dressing reduces the tension of the sutures. An urinary diversion is only necessary for larger fistulas which require a second-stage urethroplasty.
|Translated title of the contribution||Urethral fistulas after hypospadias surgery. About 74 cases|
|Number of pages||6|
|Journal||Progres en Urologie|
|Publication status||Published - 1998|
- Urethral fistula
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