Modified PATIO repair for urethrocutaneous fistula post-hypospadias repair: operative technique and outcomes.
BACKGROUND
To describe a modification of PATIO repair for urethrocutaneous fistula repair and evaluate its outcome.


METHODS
We studied 15 boys who underwent modified PATIO repair from Jan 2010 to Sept 2015. Parameters studied included age, type of hypospadias, age at first urethroplasty, hypospadias repair technique, number of urethroplasties required, location of fistula, time gap between urethroplasty and fistula repair, method of fistula repair, and outcome of fistula repair.


RESULTS
Mean age of the studied patients was 67.6 months (38-139). Type of hypospadias was Coronal = 3, subcoronal = 8, mid-penile = 2, prominal penile = 1, and penoscrotal = 1. Ten patients had single urethroplasty, while two patients had two urethroplasties, details not available for three patients. Average age at urethroplasty was 43.4 months (18-110). 12 patients had Snodgrass repair, Mathieu = 1 patient, tubularised plate repair = 1 patient, and unknown = 1 patient. Location of fistula was coronal in nine patients and subcoronal in six patients. Average operative time was 47.2 min (30-68). Follow-up is available for 12 patients out of which 2 patients had recurrent fistula, one of which was successfully treated by the redo modified PATIO method.


CONCLUSIONS
Modified PATIO method is technically easy method for urethrocutaneous fistula repair, with less operating time and good postoperative outcomes.
University Hospitals of Leicester NHS Trust, Leicester, UK. drkirtirathod@gmail.com.
Kirtikumar
http://orcid.org/0000-0002-2031-8812
K
Rathod
University Hospitals of Leicester NHS Trust, Leicester, UK.
Jaskiren
J
Loyal
University Hospitals of Leicester NHS Trust, Leicester, UK.
Bharat
B
More
University Hospitals of Leicester NHS Trust, Leicester, UK.
Ashok
A
Rajimwale
D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D061646:Operative Time; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D013524:Surgical Flaps; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014548:Urinary Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects* / Q000379:methods*
Hypospadias complications; PATIO repair; Urethrocutaneous fistula
Eur Urol. 2009 May;55(5):1027-9; discussion 1029-30
19203828
Arch Dis Child. 2007 Jul;92(7):580-4
17405856
Indian J Plast Surg. 2011 Jan;44(1):98-103
21713169
Pediatr Surg Int. 2008 Sep;24(9):1047-51
18668254
Urology. 2003 Feb;61(2):448-51
12597967
BJU Int. 2003 Oct;92(6):621-3
14511048
J Pediatr Urol. 2011 Apr;7(2):166-9
20541979
Afr J Paediatr Surg. 2010 May-Aug;7(2):124-8
20431229
BJU Int. 2009 Aug;104(4):550-4
19254282
Korean J Urol. 2012 Oct;53(10):711-5
23136632