title: A Simple Method for Closure of Urethrocutaneous Fistula after Tubularized Incised Plate Repair: Preliminary Results.
abstract: BACKGROUND
  Urethrocutaneous fistula (UCF) is the most prevalent complication after hypospadias repair surgery. Many methods have been developed for UCF correction, and the best technique for UCF repair is determined based on the size, location, and number of fistulas, as well as the status of the surrounding skin.
  
  
  OBJECTIVE
  In this study, we introduced and evaluated a simple method for UCF correction after tubularized incised plate (TIP) repair.
  
  
  METHODS
  This clinical study was conducted on children with UCFs ≤ 4 mm that developed after TIP surgery for hypospadias repair. The skin was incised around the fistula and the tract was released from the surrounding tissues and the dartos fascia, then ligated with 5 - 0 polydioxanone (PDS) sutures. The dartos fascia, as the second layer, was covered on the fistula tract with PDS thread (gauge 5 - 0) by the continuous suture method. The skin was closed with 6 - 0 Vicryl sutures. After six months of follow-up, surgical outcomes were evaluated based on fistula relapse and other complications.
  
  
  RESULTS
  After six months, relapse occurred in only one patient, a six-year-old boy with a single 4-mm distal opening, who had undergone no previous fistula repairs. Therefore, in 97.5% of the cases, relapse was non-existent. Other complications, such as urethral stenosis, intraurethral obstruction, and epidermal inclusion cysts, were not seen in the other patients during the six-month follow-up period.
  
  
  CONCLUSIONS
  This repair method, which is simple, rapid, and easily learned, is highly applicable, with a high success rate for the closure of UCFs measuring up to 4 mm in any location.
authors.affiliation: Department of Urology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Shirazi
authors.affiliation: Urology Oncology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Ariafar
authors.affiliation: Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Amir Hossein
authors.initials: AH
authors.lastname: Babaei
authors.affiliation: Department of Urology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Abdosamad
authors.initials: A
authors.lastname: Ashrafzadeh
authors.affiliation: Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Adib
keywords: Hypospadias; Tubularized Incised Plate Repair; Urethrocutaneous Fistula