title: Urethrocutaneous fistulae after hypospadias repair: When do they occur?
abstract: OBJECTIVE
  The aim is to determine the incidence and timing of urethrocutaneous fistula diagnosis after hypospadias surgery.
  
  
  METHODS
  A retrospective review of all patients who had both initial hypospadias surgery and subsequent fistula repair from 1995 to 2012. A comparison was made between patients who had an initial onlay island flap procedure and those who had a tubularised incised plate repair.
  
  
  RESULTS
  Patient age at initial surgery ranged from 6 months to 16 years of age. The median time to fistula presentation was 8.5 months with a range of less than 1 month to 13.9 years post-hypospadias surgery. The median time to fistula repair was 17 months. The overall fistula rate was 8%. There was no significant difference between the rates of fistulae for onlay island flap (9%) versus tubularised incised plate procedure (7%).
  
  
  CONCLUSIONS
  Urethrocutaneous fistulae can present many years after the original hypospadias repair. The majority are diagnosed within the first year after surgery. Rates of fistulae are probably underreported due to short follow-up, but more importantly, due to patients transferring to other surgeons for fistula repair.
authors.affiliation: Department of Urology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
authors.forename: Adelene Y
authors.initials: AY
authors.lastname: Liao
authors.affiliation: Department of Urology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
authors.forename: Grahame Hh
authors.initials: GH
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D014521:Urethra / Q000002:abnormalities* / Q000601:surgery; D014548:Urinary Fistula / Q000453:epidemiology*
keywords: hypospadias; postoperative complications; urinary fistula