ABSTRACT
Objective To study the causes of congenital hypospadias fistula and the repair methods,summarize surgical experience,and improve the success rate of fistula repair.Method s From January 2001 to February 2011,33 cases of urinary fistula after hypospadias urethroplasty were collected,the average age being 6.2 years (3 to 13 years).A total of 38 fistula were found,17 with fistula diameter of less than 3 mm,16 with fistula diameter of 3 - 10 mm,5 greater than 10 mm.Ligation embedding method were used,Y-V flap coverage method,a continuous inverted fistula suture,Thiersch method,Denis-Browne method and the U shaped flap covering method were used for multi-urinary fistula repair.Among the 33 cases,successful repair was found in 30 cases,with normal urination during flollow- up,good penile appearance,the success rate being 90.9%.Results The causes of hypospadias fistula after surgery in children are:vascularized free when properly drawn,resulting in poor blood supply to the flap; urine drainage was not smooth,resulting in premature suture wounds soaked in urine,causing infection; distal urethral stricture,high pressure within the urethra during urination,causing anastomotic dehiscence; suture materials of poor quality; technical immaturity.Conclusions The repair of urinary fistula after hypospadias in children has a variety of surgical procedures,choice of which should be based on fistula location,size,quantity and local conditions.