Urethro-cutaneous Fistula After Hypospadia Repair: A Single Institution Study

Abstract

Urethro-cutaneous fistula (UCF) is one of the most frequently seen complications of hypospadias surgery requiring re-operation; it occurs with an incidence of between 4% and 28%. Risk factors associated with the development of UCF can be classified as preoperative, intraoperative or postoperative. The aim of this study was to determine the association of peri-operative risk factors and the development of urethrocutaneous fistula after hypospadias repair. A retrospective review of patients who had undergone hypospadias repair at Kenyatta National Hospital between 2013 and 2017 was conducted. 114 patient records were retrieved. The incidence of UCF was 47%. Risk factors that were significantly associated with UCF are hypospadias type (p=0.028), lack of a protective intermediate layer (p=0.002), and presence of postoperative complications (p=0.001). Age at surgery, suture material, type of repair and use of catheter/stents were not significant factors. Multivariate analysis showed wound infection and meatal stenosis as the most significant factors associated with UCF development.

Keywords

• hypospadias
• urethro-cutaneous fistula
• risk factors
• wound infection
• meatal stenosis