title: A policy in the management of urethral fistula.
abstract: Our experience with repair of urethral fistula in 33 patients over a 5-year period is reviewed. The ages ranged from 2 to 12 years with an average of 8 years. Meatal advancement and glanuloplasty (MAGPI) were performed in five patients; there was no recurrence. A layered repair was used in 26 patients; of these, 12 recurred. Twelve patients needed a second operation and, of these, one had urethral dilatation with spontaneous cure of the fistula and the remaining 11 had a layered repair with a recurrence in five. Five patients had a third repair with further recurrence in three. Suprapubic urinary division was used in 13 cases with a failure rate of 77% (10 cases), while transurethral drainage was used in 31 cases with a failure rate of 35% (11 cases). Three of the cases with a MAGPI procedure had no urinary division. It is concluded that the MAGPI principle should be used in the repair of coronal and some subcoronal urethral fistulae as it carries a good healing rate with a short hospital stay. Transurethral bladder drainage should be used more frequently.
authors.affiliation: Department of Paediatric Surgery, Ibn Sina Hospital, Kuwait.
authors.forename: E H
authors.initials: EH
authors.lastname: Mahfouz
authors.forename: M A
authors.initials: MA
authors.lastname: Issa
authors.forename: M H
authors.initials: MH
authors.lastname: Hamdy
mesh_terms: D002648:Child; D002675:Child, Preschool; D005402:Fistula / Q000601:surgery*; D006801:Humans; D008297:Male; D010413:Penis / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D012871:Skin Diseases / Q000601:surgery*; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery; D014522:Urethral Diseases / Q000601:surgery*; D014548:Urinary Fistula / Q000601:surgery*