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ORIGINAL ARTICLE
Year : 2017  |  Volume : 9  |  Issue : 2  |  Page : 141-144

Role of tubularization of urethral plate in development of urethrocutaneous fistula post hypospadias repair


1 Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City; Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
2 Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
3 Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
4 Department of Surgery, Urology Section, College of Medicine, Umm Al Qura University, Makkah, Saudi Arabia
5 Department of Surgery, Urology Section, College of Medicine, Ibn Sina College, Jeddah, Saudi Arabia

Correspondence Address:
Abdullah K Mohammedkhalil
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 2407, Jeddah 21451
Saudi Arabia
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DOI: 10.4103/UA.UA_152_16

PMID: 28479764

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Introduction: This study aimed to demonstrate the outcome of hypospadias repair in the pediatric population using the tubularized urethral plate technique and to compare the incidence of fistula between incised and unincised urethral plate. Methodology: This is a retrospective cohort study of pediatric patients who had hypospadias repair in a tertiary hospital in Jeddah, Saudi Arabia, between January 2000 and December 2012. They were divided into two main groups according to the status of the urethral plate: Group A included patients who had incision of the urethral plate just before tubularization, and Group B included patients who underwent tubularization without incision. Results: After reviewing 310 medical records, 106 patients were included in the final analysis, with a median age of 2 years (interquartile range = 3 years). There was no statistically significant relationship between types of hypospadias and the development of fistula (P = 0.26). In Group A, we identified 87 patients (82%), and in Group B, there were 19 patients (18%). The overall incidence of fistula was 34.9% (n = 37). The incidence of fistula in Groups A and B was 36% (n = 31) and 32% (n = 6), respectively. This difference was not statistically significant. Despite a high fistula rate, only 12 patients (11%) were required to repeat surgery. Conclusion: Incision of the urethral plate did not affect the fistula rate. In comparison to international literature, the incidence of fistula was significantly higher which could be explained by the fact that one-third of those patients had a previous hypospadias repair.


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