Single-donor fibrin sealant for repair of urethrocutaneous fistulae following multiple hypospadias and epispadias repairs.
OBJECTIVE
To evaluate the efficacy of fibrin sealant for repair of urethrocutaneous fistula after multiple failed hypospadias and epispadias surgeries.


METHODS
The study population comprised 11 boys (mean age 12.18 years) with history of hypospadias or epispadias and at least two failed fistula repair operations leading to recurrent urethrocutaneous fistula. During the operation, single-donor fibrin glue, either from the patient (7) or a parent (4), was applied over the suture lines and beneath the skin. A urethral catheter was kept in place for 7-10 days. Follow up ranged from 6 to 24 months (mean 12.63 months).


RESULTS
Nine patients had an uneventful postoperative course. In one patient with a large fistula, partial wound dehiscence occurred. In another patient with complete hypospadias, hematoma formation caused skin dehiscence but the urethra remained intact. Both cases recovered after 6 months with no further intervention. No fistula recurrence was reported during follow up.


CONCLUSIONS
Single-donor fibrin glue could be a useful adjunct to surgical management of patients after multiple failed attempts at hypospadias or epispadias fistula repair. Moreover, this product improves the safety margin regarding the risk of disease transmission.
Kajbafzadeh
Abdol-Mohammad
AM
Pediatric Urology Research Center, Pediatric Center of Excellence, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran. kajbafzd@sina.tums.ac.ir
Abolghasemi
Hassan
H
Eshghi
Peyman
P
Alizadeh
Farshid
F
Elmi
Azadeh
A
Shafaattalab
Saman
S
Dianat
Seyedsaeid
S
Amirizadeh
Naser
N
Mohseni
Mohammad Javad
MJ
D000293:Adolescent; D002648:Child; D062109:Dermatologic Surgical Procedures; D004842:Epispadias / Q000601:surgery*; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery*; D012086:Reoperation / Q000009:adverse effects; D012867:Skin / Q000473:pathology; D014014:Tissue Adhesives / Q000627:therapeutic use; D014521:Urethra / Q000473:pathology / Q000601:surgery; D014548:Urinary Fistula / Q000209:etiology / Q000473:pathology / Q000601:surgery*
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives