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Timing of the Presentation of Urethrocutaneous Fistulas After Hypospadias Repair in Pediatric Patients

2008; Lippincott Williams & Wilkins; Volume: 180; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2008.03.112

1527-3792

Hadley Wood, Robert Kay, Kenneth W. Angermeier, Jonathan H. Ross,

Urinary and Genital Oncology Studies

No AccessJournal of UrologyPenis/Hypospadias1 Oct 2008Timing of the Presentation of Urethrocutaneous Fistulas After Hypospadias Repair in Pediatric Patients Hadley M. Wood, Robert Kay, Kenneth W. Angermeier, and Jonathan H. Ross Hadley M. WoodHadley M. Wood More articles by this author , Robert KayRobert Kay More articles by this author , Kenneth W. AngermeierKenneth W. Angermeier Financial interest and/or other relationship with American Medical Systems, and Engineers and Doctors. More articles by this author , and Jonathan H. RossJonathan H. Ross More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2008.03.112AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the timing of the presentation of urethrocutaneous fistulas after hypospadias repair and the development of recurrent urethrocutaneous fistulas after prior fistula repair. Materials and Methods: We reviewed the charts of all patients with urethrocutaneous fistulas following hypospadias repair who were seen from 1995 to 2005. Age at hypospadias repair, hypospadias level, hypospadias repair type, time when the parent/patient noted the fistula, date/type of fistula repair, time when fistula recurrence was noticed, date/type of secondary repair and date of last followup were documented. Results: A total of 26 patients with urethrocutaneous fistula were seen, of whom 15 had undergone at least 1 prior operation elsewhere. Of the patients 58% and 61% with fistulas following hypospadias repair and recurrent fistulas following the initial fistula, respectively, presented in the immediate postoperative period. Of the patients 23% with initial fistulas presented more than 2 years after hypospadias repair (up to 17 years later), while only 5.5% with recurrent fistulas presented more than 1 year after fistula repair. Age at presentation with initial fistulas after hypospadias repair was 0 to 12 months in 5 patients, 12 to 24 in 6, 24 to 36 in 6, 36 to 48 in 2 and more than 48 in 7. Mean followup was 5.5 months (range 0 to 69). Conclusions: While many urethrocutaneous fistulas develop immediately following hypospadias repair, almost a quarter present well beyond the typical followup of many urologists. These findings suggest that reported rates of urethrocutaneous fistula may be underestimated and longer followup may be warranted. Late recurrence of urethrocutaneous fistula is rare with 5.2% seen at more than 1 year, suggesting that more limited followup may be appropriate in these patients. References 1 : Time course and histology of urethrocutaneous fistula formation in a porcine model of urethral healing. Eur Urol2004; 45: 806. Google Scholar 2 : Failed hypospadias repair presenting in adults. Eur Urol2006; 49: 887. 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Google Scholar Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited bySnodgrass W and Bush N (2022) Do New Complications Develop during Puberty after Childhood Hypospadias Repair?Journal of Urology, VOL. 208, NO. 3, (696-701), Online publication date: 1-Sep-2022.Lucas J, Hightower T, Weiss D, Van Batavia J, Coelho S, Srinivasan A, Shukla A, Zderic S, Kolon T, Zaontz M, Canning D and Long C (2020) Time to Complication Detection after Primary Pediatric Hypospadias Repair: A Large, Single Center, Retrospective Cohort AnalysisJournal of Urology, VOL. 204, NO. 2, (338-344), Online publication date: 1-Aug-2020.Long C, Chu D, Tenney R, Morris A, Weiss D, Shukla A, Srinivasan A, Zderic S, Kolon T and Canning D (2016) Intermediate-Term Followup of Proximal Hypospadias Repair Reveals High Complication RateJournal of Urology, VOL. 197, NO. 3 Part 2, (852-858), Online publication date: 1-Mar-2017.Braga L, Jegatheeswaran K, McGrath M, Easterbrook B, Rickard M, DeMaria J and Lorenzo A (2016) Cause and Effect versus Confounding—Is There a True Association between Caudal Blocks and Tubularized Incised Plate Repair Complications?Journal of Urology, VOL. 197, NO. 3 Part 2, (845-851), Online publication date: 1-Mar-2017.Castagnetti M, Zhapa E and Rigamonti W (2012) Primary Severe Hypospadias: Comparison of Reoperation Rates and Parental Perception of Urinary Symptoms and Cosmetic Outcomes Among 4 RepairsJournal of Urology, VOL. 189, NO. 4, (1508-1513), Online publication date: 1-Apr-2013. Volume 180Issue 4SOctober 2008Page: 1753-1756 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsreconstructive surgical proceduresfistulaurethrahypospadiaspenisMetricsAuthor Information Hadley M. Wood More articles by this author Robert Kay More articles by this author Kenneth W. Angermeier Financial interest and/or other relationship with American Medical Systems, and Engineers and Doctors. More articles by this author Jonathan H. Ross More articles by this author Expand All Advertisement PDF downloadLoading ...