RESUMO
The outcome of the different surgical techniques used in our department for closure of urethrocutaneous fistulae [UCF complicating various types of hypospadias repair is evaluated. Simple, multi-layered closure and skin bridge operations were the commonest procedures used in this respect. The study comprised 120 patients undergoing UCF repair between 1998 and 2004. Out of the 120 patients, only 85 patients were available for postoperative follow up and evaluation. The median [range] age at primary fistula repair was 60 [30-180] months and the median follow up duration after the most recent repair was three years. Patients were categorized into 3 main groups; Group I included 28 patients [33.5% of the studied group] had simple closure of their UCF with successful outcome in 20 case [71%]. Group II involved 46 patients representing 54% of the studied group underwent multi-layered closure of their fistulae with successful results in 37 patients [82.5%]. Group III comprised 7 patients [8%] of the studied population for whom a skin bridge operation was done with successful outcome in 6 cases [85%]. The remaining 4 cases [4.5%] required repair of their fistulae using a Snodgrass technique with successful outcome. The overall success rate after primary fistula repair was reported in 63 cases [78%]. Fistulae larger than 2 mm [12 case] tended to re-fistulate in 50% of cases [6 cases]. Also multiple fistulae [14 case] showed greater tendency for recurrence as seen in 9 cases [65%]. After secondary repair for recurrent fistulae the success rate increased up to 22 case [78.5%] in Group I, up to 41 case [89%] in Group II and up to 7 patients [100%] in Group III. All failures, whether after primary or secondary repairs were caused by wound infection. From the above mentioned results it can be concluded that the overall success rate after multi-layer closure [89%] is much superior than the successful outcome after simple closure [78.5%] P < 0.05 while skin bridge oper