Urethro-cutaneous fistula: a rare complication in anti-incontinence surgery with trans-obturator tapes sling

This case report presents a rare complication of tension-free mid-urethral tape surgery by the obturator approach (TOT) in the form of a urethro-cutaneous fistula. The patient underwent successful surgical repair, highlighting the importance of intraoperative cystoscopy to minimize surgical risks and complications. Tension-free mid-urethral tape surgery is a commonly performed procedure for the treatment of stress urinary incontinence (SUI). However, complications can occur, albeit rarely. In this case, a 52-year-old female patient developed a urethro-cutaneous fistula following TOT surgery. The fistula was identified by the presence of urine leakage at the right inguinal level, leading to significant distress and discomfort for the patient. Prompt diagnosis and appropriate management are crucial in such cases. The patient underwent surgical repair, which involved excision of the fistulous tract. The procedure was successful, resulting in complete resolution of the fistula and restoration of normal urinary function. In conclusion, this case report highlights the occurrence of a rare complication, namely a urethro-cutaneous fistula, following TOT surgery. The successful surgical repair emphasizes the importance of prompt diagnosis and appropriate management. Furthermore, the authors propose that an intraoperative cystoscopic evaluation be considered, even after a TOT procedure. Especially in cases that present risk factors or in hospital-school institutions. By implementing this practice, surgeons can enhance patient safety and improve surgical outcomes in anti-incontinence procedures.

Complications Of Hypospadias Surgery Experience In A Tertiary Hospital

Background:To review the types of operations done for hypospadias to analyze the results and complications of different operations.Material And Methods:Patient case file and operation theater records of 40 pediatric patients from august 2020-July2021 used to obtain the required data.The age at surgery, types of hypospadias at presentation, types of operations done, complications, and results of surgeries were analyzed over a 1-year period. Result:This study in the pediatric age group showed the most common type of hypospadias being distal penile (45%) for which most common surgery being performed is Snodgrass (TIPU) (69%) with no acute (80%) and chronic complication (75%) at time of discharge. Complications rate highest when used for distal hypospadias(3-33 %). Commonest complication noted in literature is urethro-cutaneous fistula (29%). Also fistula rate is higher when TIPU is used for posterior hypospadias. Conclusion:Despite most challenging surgery in hypospadias, one may achieve desirable results by selecting appropriate surgical approaches in these patients. Careful selection of patients and attention to detailed technical factors may help reduce the complication rate. TIPU remains good option for most patients with anterior hypospadias.