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Tuesday, March 11, 2014
Urinary and Genital Disorders (Children)
Fistula Repair After Hypospadias Surgery
My son had hypospadias repair when he was 6 months old. Now 2 1/2 years old, I noticed while he was standing up to go urinate, there was a stream of urine coming out the tip as well as the bottom. He is now scheduled for fistula repair with his urologist. What is the process for repairing a fistula and is there a need for a catheter while healing?
Most fistula repairs are straightforward. The urologist typically checks to be certain that the urethra beyond the fistula is normal size, as urethral narrowing may need to be corrected also. Closure of the fistula involves excising it, closing the urethra, and then placing one or two layers of well-vascularized tissue over it to maximize the chance for satisfactory healing. Many urologists do not leave a catheter for this procedure if the fistula is small and the operation goes smoothly, but I almost always leave one.
Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University