Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases

Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized ela...
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Autor*in:	Yogender Singh Kadian [verfasserIn] Kamal Nain Rattan [verfasserIn] Jagjit Singh [verfasserIn] Mahavir Singh [verfasserIn] Pradeep Kajal [verfasserIn] Dheeraj Parihar [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2011

Schlagwörter:	Hypospadias repair tunica vaginalis flap urethrocutaneous fistula

Übergeordnetes Werk:	In: African Journal of Paediatric Surgery - Wolters Kluwer Medknow Publications, 2008, 8(2011), 2, Seite 164-167
Übergeordnetes Werk:	volume:8 ; year:2011 ; number:2 ; pages:164-167

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.4103/0189-6725.86054

Katalog-ID:	DOAJ073109320

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520			\|a Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue. We report our experience of using the tunica vaginalis flap as a layer between the neourethra and skin suture line in repair of recurrent urethrocutaneous fistula. Patients and Methods: We have used the tunica vaginalis flap for the repair of recurrent urethrocutaneous fistula in 14 children with a mean age of 6.5 years (range 3-14 years). All patients had undergone previous hypospadias repair and at least one previous attempt to close the fistula had failed. Surgery was initiated by injecting a povidone solution via urethral meatus to identify all fistulae. The fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested either through a small scrotal incision and mobilized via a subcutaneous tunnel into the penile shaft (8/14) or by the same incision as for fistula closure (6/14). The testis was fixed to the scrotum. A urethral catheter was kept for urinary diversion for 10 days. Results: The repair was successful in all but one patient in whom there was leak from the fistula site. One patient in whom tunica vaginalis fascia was tunnelled into neourethra developed scrotal haematoma which needed drainage. Penile cosmesis was acceptable without any significant postoperative testicular complication in 13/14 patients. Conclusion: Repair of recurrent urethrocutaneous fistula with a tunica vaginalis flap is highly effective regardless of fistula location. This flap is easy to mobilize and provide effective coverage of urethral suture line. Putting a glove drain should be considered into scrotal wound if perfect haemostasis is doubtful.
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allfields	10.4103/0189-6725.86054 doi (DE-627)DOAJ073109320 (DE-599)DOAJ572c154e97b149b185d6fd92faabd0e9 DE-627 ger DE-627 rakwb eng RJ1-570 RD1-811 Yogender Singh Kadian verfasserin aut Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue. We report our experience of using the tunica vaginalis flap as a layer between the neourethra and skin suture line in repair of recurrent urethrocutaneous fistula. Patients and Methods: We have used the tunica vaginalis flap for the repair of recurrent urethrocutaneous fistula in 14 children with a mean age of 6.5 years (range 3-14 years). All patients had undergone previous hypospadias repair and at least one previous attempt to close the fistula had failed. Surgery was initiated by injecting a povidone solution via urethral meatus to identify all fistulae. The fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested either through a small scrotal incision and mobilized via a subcutaneous tunnel into the penile shaft (8/14) or by the same incision as for fistula closure (6/14). The testis was fixed to the scrotum. A urethral catheter was kept for urinary diversion for 10 days. Results: The repair was successful in all but one patient in whom there was leak from the fistula site. One patient in whom tunica vaginalis fascia was tunnelled into neourethra developed scrotal haematoma which needed drainage. Penile cosmesis was acceptable without any significant postoperative testicular complication in 13/14 patients. Conclusion: Repair of recurrent urethrocutaneous fistula with a tunica vaginalis flap is highly effective regardless of fistula location. This flap is easy to mobilize and provide effective coverage of urethral suture line. Putting a glove drain should be considered into scrotal wound if perfect haemostasis is doubtful. Hypospadias repair tunica vaginalis flap urethrocutaneous fistula Pediatrics Surgery Kamal Nain Rattan verfasserin aut Jagjit Singh verfasserin aut Mahavir Singh verfasserin aut Pradeep Kajal verfasserin aut Dheeraj Parihar verfasserin aut In African Journal of Paediatric Surgery Wolters Kluwer Medknow Publications, 2008 8(2011), 2, Seite 164-167 (DE-627)54812454X (DE-600)2392865-7 09745998 nnns volume:8 year:2011 number:2 pages:164-167 https://doi.org/10.4103/0189-6725.86054 kostenfrei https://doaj.org/article/572c154e97b149b185d6fd92faabd0e9 kostenfrei http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2011;volume=8;issue=2;spage=164;epage=167;aulast=Kadian kostenfrei https://doaj.org/toc/0189-6725 Journal toc kostenfrei https://doaj.org/toc/0974-5998 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2011 2 164-167
spelling	10.4103/0189-6725.86054 doi (DE-627)DOAJ073109320 (DE-599)DOAJ572c154e97b149b185d6fd92faabd0e9 DE-627 ger DE-627 rakwb eng RJ1-570 RD1-811 Yogender Singh Kadian verfasserin aut Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue. We report our experience of using the tunica vaginalis flap as a layer between the neourethra and skin suture line in repair of recurrent urethrocutaneous fistula. Patients and Methods: We have used the tunica vaginalis flap for the repair of recurrent urethrocutaneous fistula in 14 children with a mean age of 6.5 years (range 3-14 years). All patients had undergone previous hypospadias repair and at least one previous attempt to close the fistula had failed. Surgery was initiated by injecting a povidone solution via urethral meatus to identify all fistulae. The fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested either through a small scrotal incision and mobilized via a subcutaneous tunnel into the penile shaft (8/14) or by the same incision as for fistula closure (6/14). The testis was fixed to the scrotum. A urethral catheter was kept for urinary diversion for 10 days. Results: The repair was successful in all but one patient in whom there was leak from the fistula site. One patient in whom tunica vaginalis fascia was tunnelled into neourethra developed scrotal haematoma which needed drainage. Penile cosmesis was acceptable without any significant postoperative testicular complication in 13/14 patients. Conclusion: Repair of recurrent urethrocutaneous fistula with a tunica vaginalis flap is highly effective regardless of fistula location. This flap is easy to mobilize and provide effective coverage of urethral suture line. Putting a glove drain should be considered into scrotal wound if perfect haemostasis is doubtful. Hypospadias repair tunica vaginalis flap urethrocutaneous fistula Pediatrics Surgery Kamal Nain Rattan verfasserin aut Jagjit Singh verfasserin aut Mahavir Singh verfasserin aut Pradeep Kajal verfasserin aut Dheeraj Parihar verfasserin aut In African Journal of Paediatric Surgery Wolters Kluwer Medknow Publications, 2008 8(2011), 2, Seite 164-167 (DE-627)54812454X (DE-600)2392865-7 09745998 nnns volume:8 year:2011 number:2 pages:164-167 https://doi.org/10.4103/0189-6725.86054 kostenfrei https://doaj.org/article/572c154e97b149b185d6fd92faabd0e9 kostenfrei http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2011;volume=8;issue=2;spage=164;epage=167;aulast=Kadian kostenfrei https://doaj.org/toc/0189-6725 Journal toc kostenfrei https://doaj.org/toc/0974-5998 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2011 2 164-167
allfields_unstemmed	10.4103/0189-6725.86054 doi (DE-627)DOAJ073109320 (DE-599)DOAJ572c154e97b149b185d6fd92faabd0e9 DE-627 ger DE-627 rakwb eng RJ1-570 RD1-811 Yogender Singh Kadian verfasserin aut Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue. We report our experience of using the tunica vaginalis flap as a layer between the neourethra and skin suture line in repair of recurrent urethrocutaneous fistula. Patients and Methods: We have used the tunica vaginalis flap for the repair of recurrent urethrocutaneous fistula in 14 children with a mean age of 6.5 years (range 3-14 years). All patients had undergone previous hypospadias repair and at least one previous attempt to close the fistula had failed. Surgery was initiated by injecting a povidone solution via urethral meatus to identify all fistulae. The fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested either through a small scrotal incision and mobilized via a subcutaneous tunnel into the penile shaft (8/14) or by the same incision as for fistula closure (6/14). The testis was fixed to the scrotum. A urethral catheter was kept for urinary diversion for 10 days. Results: The repair was successful in all but one patient in whom there was leak from the fistula site. One patient in whom tunica vaginalis fascia was tunnelled into neourethra developed scrotal haematoma which needed drainage. Penile cosmesis was acceptable without any significant postoperative testicular complication in 13/14 patients. Conclusion: Repair of recurrent urethrocutaneous fistula with a tunica vaginalis flap is highly effective regardless of fistula location. This flap is easy to mobilize and provide effective coverage of urethral suture line. Putting a glove drain should be considered into scrotal wound if perfect haemostasis is doubtful. Hypospadias repair tunica vaginalis flap urethrocutaneous fistula Pediatrics Surgery Kamal Nain Rattan verfasserin aut Jagjit Singh verfasserin aut Mahavir Singh verfasserin aut Pradeep Kajal verfasserin aut Dheeraj Parihar verfasserin aut In African Journal of Paediatric Surgery Wolters Kluwer Medknow Publications, 2008 8(2011), 2, Seite 164-167 (DE-627)54812454X (DE-600)2392865-7 09745998 nnns volume:8 year:2011 number:2 pages:164-167 https://doi.org/10.4103/0189-6725.86054 kostenfrei https://doaj.org/article/572c154e97b149b185d6fd92faabd0e9 kostenfrei http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2011;volume=8;issue=2;spage=164;epage=167;aulast=Kadian kostenfrei https://doaj.org/toc/0189-6725 Journal toc kostenfrei https://doaj.org/toc/0974-5998 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2011 2 164-167
allfieldsGer	10.4103/0189-6725.86054 doi (DE-627)DOAJ073109320 (DE-599)DOAJ572c154e97b149b185d6fd92faabd0e9 DE-627 ger DE-627 rakwb eng RJ1-570 RD1-811 Yogender Singh Kadian verfasserin aut Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue. We report our experience of using the tunica vaginalis flap as a layer between the neourethra and skin suture line in repair of recurrent urethrocutaneous fistula. Patients and Methods: We have used the tunica vaginalis flap for the repair of recurrent urethrocutaneous fistula in 14 children with a mean age of 6.5 years (range 3-14 years). All patients had undergone previous hypospadias repair and at least one previous attempt to close the fistula had failed. Surgery was initiated by injecting a povidone solution via urethral meatus to identify all fistulae. The fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested either through a small scrotal incision and mobilized via a subcutaneous tunnel into the penile shaft (8/14) or by the same incision as for fistula closure (6/14). The testis was fixed to the scrotum. A urethral catheter was kept for urinary diversion for 10 days. Results: The repair was successful in all but one patient in whom there was leak from the fistula site. One patient in whom tunica vaginalis fascia was tunnelled into neourethra developed scrotal haematoma which needed drainage. Penile cosmesis was acceptable without any significant postoperative testicular complication in 13/14 patients. Conclusion: Repair of recurrent urethrocutaneous fistula with a tunica vaginalis flap is highly effective regardless of fistula location. This flap is easy to mobilize and provide effective coverage of urethral suture line. Putting a glove drain should be considered into scrotal wound if perfect haemostasis is doubtful. Hypospadias repair tunica vaginalis flap urethrocutaneous fistula Pediatrics Surgery Kamal Nain Rattan verfasserin aut Jagjit Singh verfasserin aut Mahavir Singh verfasserin aut Pradeep Kajal verfasserin aut Dheeraj Parihar verfasserin aut In African Journal of Paediatric Surgery Wolters Kluwer Medknow Publications, 2008 8(2011), 2, Seite 164-167 (DE-627)54812454X (DE-600)2392865-7 09745998 nnns volume:8 year:2011 number:2 pages:164-167 https://doi.org/10.4103/0189-6725.86054 kostenfrei https://doaj.org/article/572c154e97b149b185d6fd92faabd0e9 kostenfrei http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2011;volume=8;issue=2;spage=164;epage=167;aulast=Kadian kostenfrei https://doaj.org/toc/0189-6725 Journal toc kostenfrei https://doaj.org/toc/0974-5998 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2011 2 164-167
allfieldsSound	10.4103/0189-6725.86054 doi (DE-627)DOAJ073109320 (DE-599)DOAJ572c154e97b149b185d6fd92faabd0e9 DE-627 ger DE-627 rakwb eng RJ1-570 RD1-811 Yogender Singh Kadian verfasserin aut Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue. We report our experience of using the tunica vaginalis flap as a layer between the neourethra and skin suture line in repair of recurrent urethrocutaneous fistula. Patients and Methods: We have used the tunica vaginalis flap for the repair of recurrent urethrocutaneous fistula in 14 children with a mean age of 6.5 years (range 3-14 years). All patients had undergone previous hypospadias repair and at least one previous attempt to close the fistula had failed. Surgery was initiated by injecting a povidone solution via urethral meatus to identify all fistulae. The fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested either through a small scrotal incision and mobilized via a subcutaneous tunnel into the penile shaft (8/14) or by the same incision as for fistula closure (6/14). The testis was fixed to the scrotum. A urethral catheter was kept for urinary diversion for 10 days. Results: The repair was successful in all but one patient in whom there was leak from the fistula site. One patient in whom tunica vaginalis fascia was tunnelled into neourethra developed scrotal haematoma which needed drainage. Penile cosmesis was acceptable without any significant postoperative testicular complication in 13/14 patients. Conclusion: Repair of recurrent urethrocutaneous fistula with a tunica vaginalis flap is highly effective regardless of fistula location. This flap is easy to mobilize and provide effective coverage of urethral suture line. Putting a glove drain should be considered into scrotal wound if perfect haemostasis is doubtful. Hypospadias repair tunica vaginalis flap urethrocutaneous fistula Pediatrics Surgery Kamal Nain Rattan verfasserin aut Jagjit Singh verfasserin aut Mahavir Singh verfasserin aut Pradeep Kajal verfasserin aut Dheeraj Parihar verfasserin aut In African Journal of Paediatric Surgery Wolters Kluwer Medknow Publications, 2008 8(2011), 2, Seite 164-167 (DE-627)54812454X (DE-600)2392865-7 09745998 nnns volume:8 year:2011 number:2 pages:164-167 https://doi.org/10.4103/0189-6725.86054 kostenfrei https://doaj.org/article/572c154e97b149b185d6fd92faabd0e9 kostenfrei http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2011;volume=8;issue=2;spage=164;epage=167;aulast=Kadian kostenfrei https://doaj.org/toc/0189-6725 Journal toc kostenfrei https://doaj.org/toc/0974-5998 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2011 2 164-167
language	English
source	In African Journal of Paediatric Surgery 8(2011), 2, Seite 164-167 volume:8 year:2011 number:2 pages:164-167
sourceStr	In African Journal of Paediatric Surgery 8(2011), 2, Seite 164-167 volume:8 year:2011 number:2 pages:164-167
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Hypospadias repair tunica vaginalis flap urethrocutaneous fistula Pediatrics Surgery
isfreeaccess_bool	true
container_title	African Journal of Paediatric Surgery
authorswithroles_txt_mv	Yogender Singh Kadian @@aut@@ Kamal Nain Rattan @@aut@@ Jagjit Singh @@aut@@ Mahavir Singh @@aut@@ Pradeep Kajal @@aut@@ Dheeraj Parihar @@aut@@
publishDateDaySort_date	2011-01-01T00:00:00Z
hierarchy_top_id	54812454X
id	DOAJ073109320
language_de	englisch
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callnumber-first	R - Medicine
author	Yogender Singh Kadian
spellingShingle	Yogender Singh Kadian misc RJ1-570 misc RD1-811 misc Hypospadias repair misc tunica vaginalis flap misc urethrocutaneous fistula misc Pediatrics misc Surgery Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases
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topic_title	RJ1-570 RD1-811 Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases Hypospadias repair tunica vaginalis flap urethrocutaneous fistula
topic	misc RJ1-570 misc RD1-811 misc Hypospadias repair misc tunica vaginalis flap misc urethrocutaneous fistula misc Pediatrics misc Surgery
topic_unstemmed	misc RJ1-570 misc RD1-811 misc Hypospadias repair misc tunica vaginalis flap misc urethrocutaneous fistula misc Pediatrics misc Surgery
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title	Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases
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title_full	Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases
author_sort	Yogender Singh Kadian
journal	African Journal of Paediatric Surgery
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author_browse	Yogender Singh Kadian Kamal Nain Rattan Jagjit Singh Mahavir Singh Pradeep Kajal Dheeraj Parihar
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title_sort	tunica vaginalis: an aid in hypospadias fistula repair: our experience of 14 cases
callnumber	RJ1-570
title_auth	Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases
abstract	Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue. We report our experience of using the tunica vaginalis flap as a layer between the neourethra and skin suture line in repair of recurrent urethrocutaneous fistula. Patients and Methods: We have used the tunica vaginalis flap for the repair of recurrent urethrocutaneous fistula in 14 children with a mean age of 6.5 years (range 3-14 years). All patients had undergone previous hypospadias repair and at least one previous attempt to close the fistula had failed. Surgery was initiated by injecting a povidone solution via urethral meatus to identify all fistulae. The fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested either through a small scrotal incision and mobilized via a subcutaneous tunnel into the penile shaft (8/14) or by the same incision as for fistula closure (6/14). The testis was fixed to the scrotum. A urethral catheter was kept for urinary diversion for 10 days. Results: The repair was successful in all but one patient in whom there was leak from the fistula site. One patient in whom tunica vaginalis fascia was tunnelled into neourethra developed scrotal haematoma which needed drainage. Penile cosmesis was acceptable without any significant postoperative testicular complication in 13/14 patients. Conclusion: Repair of recurrent urethrocutaneous fistula with a tunica vaginalis flap is highly effective regardless of fistula location. This flap is easy to mobilize and provide effective coverage of urethral suture line. Putting a glove drain should be considered into scrotal wound if perfect haemostasis is doubtful.
abstractGer	Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue. We report our experience of using the tunica vaginalis flap as a layer between the neourethra and skin suture line in repair of recurrent urethrocutaneous fistula. Patients and Methods: We have used the tunica vaginalis flap for the repair of recurrent urethrocutaneous fistula in 14 children with a mean age of 6.5 years (range 3-14 years). All patients had undergone previous hypospadias repair and at least one previous attempt to close the fistula had failed. Surgery was initiated by injecting a povidone solution via urethral meatus to identify all fistulae. The fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested either through a small scrotal incision and mobilized via a subcutaneous tunnel into the penile shaft (8/14) or by the same incision as for fistula closure (6/14). The testis was fixed to the scrotum. A urethral catheter was kept for urinary diversion for 10 days. Results: The repair was successful in all but one patient in whom there was leak from the fistula site. One patient in whom tunica vaginalis fascia was tunnelled into neourethra developed scrotal haematoma which needed drainage. Penile cosmesis was acceptable without any significant postoperative testicular complication in 13/14 patients. Conclusion: Repair of recurrent urethrocutaneous fistula with a tunica vaginalis flap is highly effective regardless of fistula location. This flap is easy to mobilize and provide effective coverage of urethral suture line. Putting a glove drain should be considered into scrotal wound if perfect haemostasis is doubtful.
abstract_unstemmed	Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue. We report our experience of using the tunica vaginalis flap as a layer between the neourethra and skin suture line in repair of recurrent urethrocutaneous fistula. Patients and Methods: We have used the tunica vaginalis flap for the repair of recurrent urethrocutaneous fistula in 14 children with a mean age of 6.5 years (range 3-14 years). All patients had undergone previous hypospadias repair and at least one previous attempt to close the fistula had failed. Surgery was initiated by injecting a povidone solution via urethral meatus to identify all fistulae. The fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested either through a small scrotal incision and mobilized via a subcutaneous tunnel into the penile shaft (8/14) or by the same incision as for fistula closure (6/14). The testis was fixed to the scrotum. A urethral catheter was kept for urinary diversion for 10 days. Results: The repair was successful in all but one patient in whom there was leak from the fistula site. One patient in whom tunica vaginalis fascia was tunnelled into neourethra developed scrotal haematoma which needed drainage. Penile cosmesis was acceptable without any significant postoperative testicular complication in 13/14 patients. Conclusion: Repair of recurrent urethrocutaneous fistula with a tunica vaginalis flap is highly effective regardless of fistula location. This flap is easy to mobilize and provide effective coverage of urethral suture line. Putting a glove drain should be considered into scrotal wound if perfect haemostasis is doubtful.
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title_short	Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases
url	https://doi.org/10.4103/0189-6725.86054 https://doaj.org/article/572c154e97b149b185d6fd92faabd0e9 http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2011;volume=8;issue=2;spage=164;epage=167;aulast=Kadian https://doaj.org/toc/0189-6725 https://doaj.org/toc/0974-5998
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