URETHROCUTANEOUS FISTULA IN TWO STAGED AIVAR BRACKA REPAIR OF HYPOSPADIAS
Abstract
INTRODUCTION Hypospadias is one of the most common congenital anomalies in male newborns accounting for one in 300 new born male babies. It is the ectopic presence of urethral meatus on the undersurface of the phallus. Surgery of hypsopadias is riddled with complications. Urethrocutaneous fistula complicating hypospadias repair appears the most common problem.
OBJECTIVE To determine the frequency of urethrocutaneous fistula in patients with post two staged aivarBracka repair of hypospadias.
METHODS This study was conducted at Department of Plastic and reconstructive Surgery unit, Hayatabad Medical Complex Peshawar. Study design was descriptive and cross-sectional Duration of the study was 16 months in which 82 patients were observed by using WHO formula for sample size. Non-probability consecutive sampling technique was used for sample collection.
RESULTS In this study 72% patients were in age range 3-6 years, 28% patients were in age range 7-10 years. Mean age was 3 years with SD ±1.31. Twenty percent patients had urethrocutaneous fistula while 80% patients didn’t have any fistula.
CONCLUSION Fistula rate in hypospadias repair depends on the technique as well as the learning curve of the surgeon. The commonest complication following two-stage Aivar Bracka repair of hypospadias is fistula and this study confirms it to be at a 20% occurrence.
KEY WORDS Urethrocutaneous fistula, Braka repair, Hypospadias
References
Ahmad N, Hameed A. Management of hypospadias cripple with two stage Bracka’s technique. JPRAS 2011;1(64):91-6.
Ozturk H. Dartos flap coverage of the neourethra following repair for primary hypospadias, reoperative hypospadias and urethrocutaneous fistula .it is a safe approach.Acta Cir Bras 2010;25(2):190-3.
Chung JW, Chois SH, Kim BS, Chung SK. Risk factors for the development of urethrocutaneous fistula after hypospadias repair. Korean J Urol2012; 53(10):711-5.
Holland AJA, Backer MA, Smith GHH, Class DT. Management of urethrocutaneous fistula following hypospadias repair.PediatrSurgInt2008;24: 1047-51.
Tabassi KT, Mohammadi S. Tunica vaginalis flap as a second layer for tabularized incised plate urethroplasty. Urol J. 2010;7;254-7.
Williams NS, Bulstrode CJK, O’Connell PR. Bailey and Love’s short practice of surgery. 25th ed. London: Edward Arnold; 2008. P,1362-3.
Al-Saied G, Gamal A. Versatility of tabularized incised plate urethroplasty in the management of different types of hypospadias: 5-year experience. Afr J PaediatrSurg 2009;6:88-92.
Elder JS, Duckett JW, and Snyder HM: Onlay island flap in the repair of mid and distal penile hypospadias without chordee. J Urol 1987;138:376–79.
Khan M, Majeed A, Hayat W, Hidayat, Naz S, Shah SA, et al. Hypospadias Repair: A Single Centre Experience. Plastic Surgery International 2014; 2-9
Huang L, Tang M, Wang S. Chen, “Tubularized incised plate urethroplasty for hypospadias in children,†ZhongguoXiu Fu Chong JianWaiKeZaZhi, 2006; 20:226–28
Bush NC, M. Holzer S, Zhang W. Snodgrass, “Age does not impact risk for urethroplasty complications after tubularized incised plate repair of hypospadias in prepubertal boys,†Journal of Pediatric Urology, vol. 2013;9:252–6
