Evaluation of rotational skin flap in posthypospadias urethrocutaneous fistula

Background Urethrocutaneous fistula (UCF) is a track between penile skin and urethra and is one of the most common complications after hypospadias surgery. Aim We aimed to evaluate the result of UCF closure after hypospadias repair using rotational skin flap. Patients and methods This study included 20 patients with UCF after hypospadias repair. The age of cases at the time of surgery ranged between 18 months and 14 years, and the majority were below 6 years “65%” with a mean of 55.3±24.68 months. Cases were primarily single small to moderate “2–4 mm” UCF after at least 6 months from hypospadias repair. All patients were treated using interrupted sutures closure of the fistula covered by rotational skin flap and admitted to the Pediatric Surgery Unit, Tanta University Hospital, between October 2017 and October 2018. Results Eighteen (90%) patients had normal postoperative course, good healing and normal stream, while two patients with coronal fistula were complicated by recurrence at the same site. Conclusion UCF treatment by rotational skin flap, without an intermediate layer, is 90% successful for repairing small to moderate size fistulae 2–4 mm. Urethral diversion by catheter insertion or stenting is not necessary after flap fistula repair. However, a comparative study on a larger number of patients is recommended to support these results.