EVALUATION OF FISTULA FORMATION AFTER HYPOSPADIAS SURGERY

Abstract

Abstract

The relationship between fistula formation and urethral meatus, patient´s age and the suture material used during surgery was evaluated in the patients who underwent hypospadias repair in our department between July 1995 and June 2000.

One hundred-twenty-four patients with age at the time of surgery ranged from 7 months to 32 years underwent hypospadias repair. Hundred of the patients were at the age of 15 or under (80.6%) and 24 of them were over 16 years of age (19.4%). In 25 patients (20.2%) urethral defect was in the posterior, in 37 (29.8%) in the middle and in 62 (50%) in the anterior in location. Twenty-two patients underwent MAGPI repair, 68 underwent Mathieu repair, 31 underwent transverse island flap, 1 underwent Dennis Brown repair and 2 patients underwent repair with graft insertion. In 77 of the patients; polyglactine, in 33 of the patients; polydioxanone and in 14 of the patients; chromic surgical gut were used. The follow-up of the patients was between 4 to 50 months (mean 20).

In 30 of the patients, fistula had developed. Fistula was seen in the posterior in 7 (5.6%), in the middle in 9 (7.3%) and in the anterior in 14 (11.3%) of the patients. In 27 patients who had fistulas polyglactine and in 3 patients polydioxanone had been used as a suture material. Out of 27 patients with fistula after polyglactine had been used urethral meatus was in the anterior in 13 (43.3%), in the middle in 8 (26.6%) and in the posterior in 6 (20%) patients. Out of 3 patients with fistula after polydioxanone had been used meatus was in the anterior in 1 (3.3%), in the middle in 1 (3.3%) and in the posterior in 1 (3.3%) patient. In 6 of 22 patients after MAGPI repair, in 16 of 68 patients after Mathieu repair and in 8 of 31 patients after transverse island flap repair fistula had seen.