title: Repair-oriented categorization of circumcision urethral injury in Benin city, Nigeria.
abstract: BACKGROUND
  The wide spectrum of circumcision urethral injury/fistula makes selection of appropriate repair methods challenging in sub-Saharan Africa. This paper reports on the outcome of repair-oriented categorization in a Nigerian center.
  
  
  METHODS
  Consecutive children presenting with circumcision urethral injury/fistula at the University of Benin Teaching Hospital were categorized into six repair-oriented groups in 2009-2011.
  
  
  RESULTS
  21 children were treated. Except in 2 cases, early neonatal circumcision at an average age of 8 days (range 4-14 days) had been performed, the majority (52%) by paramedics at home. Categories of injury/fistula based on severity ranged from isolated fistula (38%) which required fistula excision and repair (category A) to severe ventral urethral/coronal/glanular avulsion (29%) which required urethral plate tubularization/ventral penile reconstruction (category F). Overall, successful first-stage repair was achieved in 19 (91%) children. Meatal stenosis (2), urethral stricture (1), which responded to serial dilatation, and minor urinary leakage (2), which was closed at second stage, were the post-repair complications. Adequate penile size and straight penis on erection were achieved in all cases. Cosmetic outcome was excellent in 16 (76%) cases, good in 4 (19%) and fair in 1 (5%).
  
  
  CONCLUSIONS
  Repair-oriented categorization, which could be useful to practitioners in similar settings, was satisfactory in managing urethral injury/urethrocutaneous fistula.
authors.affiliation: Paediatric Surgery Unit, Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria. Leadekso@yahoo.com
authors.forename: Osarumwense David
authors.initials: OD
authors.lastname: Osifo
authors.forename: Helen
authors.initials: H
authors.lastname: Odion-Obomhense
authors.forename: Theophilus Osasumwen
authors.initials: TO
authors.lastname: Osagie
mesh_terms: D000488:Allied Health Personnel / Q000706:statistics & numerical data; D002944:Circumcision, Male / Q000009:adverse effects* / Q000706:statistics & numerical data; D006784:Hospitals, Teaching; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D019651:Plastic Surgery Procedures; D014521:Urethra / Q000293:injuries*; D014522:Urethral Diseases / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D014548:Urinary Fistula / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*