title: Outpatient department repair of urethrocutaneous fistulae using  n-butyl-cyanoacrylate (NBCA): a single-centre experience.
abstract: OBJECTIVE
  • To evaluate urethrocutaneous fistula repair after urethroplasty using n-butyl cyanoacrylate (NBCA) in an outpatient setting. • To compare results of application of NBCA in 'early' and long-standing fistulae.
  
  
  METHODS
  • From January 2003 to December 2006, 13 children (mean age 36 months) were treated in our Outpatient Department for urethrocutaneous fistula, which occurred after hypospadias repair. • We analysed the data dividing the patients in two groups: group A comprised six children (mean age 22.6 months) that developed a fistula within 2-3 days of catheter removal after urethroplasty ('early' fistula) and group B comprised seven children (mean age 42.6 months) with long-standing fistulae. • In all patients, a multilayer of NBCA was applied, attaching the edges of the fistula taking care to perform a scarification of the edges of the fistula in patients in group B before the application of the glue.
  
  
  RESULTS
  • Four patients in group A and three patients in group B had definitive fistula repair (seven of 13), and six of the 13 had fistula recurrence. • Fistulae of ≤ 2 mm were more easily repaired than fistulae of > 2 mm (five of seven vs two of six). • Fistulae that tended to recover were those that responded to the first applications.
  
  
  CONCLUSIONS
  • In this experience the use of NBCA as a minimally invasive treatment for fistula repair gave good results for repairing fistulae. • These preliminary results encourage the use of NBCA as a first non-surgical attempt to repair urethrocutaneous fistulae especially if the fistula is ≤2 mm. • The failure of this procedure does not compromise a possible subsequent surgical repair.
authors.affiliation: S.C. di Clinica Chirurgica Pediatrica, Università degli Studi di Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Prestipino
authors.forename: Mirko
authors.initials: M
authors.lastname: Bertozzi
authors.forename: Niccolò
authors.initials: N
authors.lastname: Nardi
authors.forename: Antonino
authors.initials: A
authors.lastname: Appignani
mesh_terms: D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000601:surgery*; D004659:Enbucrilate / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery; D007223:Infant; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery; D014522:Urethral Diseases / Q000209:etiology / Q000601:surgery*; D014548:Urinary Fistula / Q000209:etiology / Q000601:surgery*
chemical_list: D004659:Enbucrilate