title: A simple procedure for management of urethrocutaneous fistulas; post-hypospadias repair.
abstract: OBJECTIVE
  The treatment of urethral fistulas is quite challenging. We try to evaluate the results of a simple procedure in post-hypospadias urethral fistula repair.
  
  
  METHODS
  In the period from 2003 to 2007, 35 patients with 35 fistulas, with an average age 3.5 years [range: 2-8], were classified into coronal 12, mid-penile 13 and proximal 10. Based on the size they were grouped into two--either less than 5 mm (20) or more than 5 mm (15). Midline relaxing incision was used for large fistulas and then covered with a vascularised flap dartos-based flap [flip flap] in 19 and tunica vaginalis in 16. If a patient had more than one small fistula adjacent to each other, they were joined into a large single fistula and then repaired.
  
  
  RESULTS
  We have successfully repaired all urethrocutaneous fistulas using our protocol, with success rate [97.3] 1/35.
  
  
  CONCLUSIONS
  Dorsal midline urethral incision (DUMI), with dartos flip flap or tunica vaginalis coverage is an appropriate procedure to repair midline and proximal urethral fistulas.
authors.affiliation: Department of Plastic and Paediatric Surgery, Zagazig University Hospitals, Zagazig, Egypt.
authors.forename: S
authors.initials: S
authors.lastname: Mohamed
authors.forename: N
authors.initials: N
authors.lastname: Mohamed
authors.forename: T
authors.initials: T
authors.lastname: Esmael
authors.forename: Sh
authors.initials: Sh
authors.lastname: Khaled
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007021:Hypospadias / Q000150:complications / Q000601:surgery*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome; D014522:Urethral Diseases / Q000209:etiology / Q000601:surgery*; D014548:Urinary Fistula / Q000209:etiology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*