Microsurgical management of urethral fistula occurred after urethroplasty in hypospadias / 中华显微外科杂志

ABSTRACT

Objective To evaluate the role of mierosurgery in surgical treatment to urethrocutaneous fistula after urethroplasty in hypospadias and improve surgical results.Methods From 1999 to 2006,44 urethrocutaneous fistulae (more than 3mm in diameter) after urethroplasty for hypospadias in 33 patients were repaired with different skin flaps.For example,Thiersch technique,urthroplasty,etc.Microsurgical tech- nique was employed in every case.Results The success rates of different procedure were 84.8% (28/33) for Thiersch technique,100% (11/11) for urethroplasty respectively.The total success rate was 88.6%(39/ 44).Conclusion It's just application of skin flap for repairing of big or complex urinary fistula after hypos- padias surgery.The application of microsurgical technique can increase success rate.It is necessary to excise scar and partial urethra for hypospadias fistula combined with urethral structures,cicatricial eontracture and in- curvation of penis.Rich blood-supply,low tension and atraumatic technique are all very important to improve surgery success rates of urinary,fistula after hypospadias repair.