title: Tubularized incised plate urethroplasty for the treatment of penile fistulas after hypospadias repair.
abstract: OBJECTIVE
  Urethrocutaneous fistula is the most common complication of hypospadias repair. Tubularized incised plate urethroplasty (TIPU) has been used for the management of distal fistulas. This study reports the usage of TIPU in the treatment of large penile fistulas.
  
  
  METHODS
  Between April 2002 and September 2012, 15 patients with large penile fistulas who were managed with TIPU were included in the study. The fistulas were sited along the penile shaft from proximal to distal penile localization. Glanular and coronal fistulas were excluded. The surgical technique was completed according to the standard TIPU technique. The surrounding scar tissue of the fistula was circumferentially excised, and the urethral plate at the level of the fistula was incised to provide performance of loose urethral tubularization. A urethral stent was kept for 5-7 days.
  
  
  RESULTS
  The mean age of the patients was 7.3 ± 3.1 years. Primary operation of these patients was tubularized preputial island flap (n = 6), on-lay preputial island flap (n = 4), and TIPU (n = 5). The sites of the hypospadias fistulas were as follows; penoscrotal (three), mid-penile (eight) and subcoronal (four). Fistulas recurred in two patients after fistula repair. The postoperative follow up of the patients was 12.4 ± 7.7 months.
  
  
  CONCLUSIONS
  TIPU may be used safely for the treatment of fistulas after hypospadias repair.
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey. Electronic address: osman.karakus@deu.edu.tr.
authors.forename: O Z
authors.initials: OZ
authors.lastname: Karakuş
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Ateş
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Tekin
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Hakgüder
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Olguner
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: F M
authors.initials: FM
authors.lastname: Akgür
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D010409:Penile Diseases / Q000209:etiology / Q000601:surgery*; D010413:Penis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*
keywords: Hypospadias repair; Penile fistula; Tubularized plate incised urethroplasty; Urethral fistula