Advances in Urology 
Volume 2008 (2008), Article ID 615928, 3 pages
doi:10.1155/2008/615928
Clinical Study

Tunneled Tunica Vaginalis Flap for Recurrent Urethrocutaneous Fistulae

Jonathan C. Routh,1 James J. Wolpert,2 and Yuri Reinberg2

 1Department of Urology, Mayo Clinic, Rochester, MN 55905, USA
2Division of Pediatric Urology, Pediatric Surgical Associates, Minneapolis, MN 55404, USA
Received 19 April 2008; Accepted 11 August 2008

Recommended by Miroslav L. Djordjevic

Abstract

The tubularized incised plate (TIP) hypospadias repair is currently the most widely used urethroplasty technique. The most significant post-TIP complication is urethrocutaneous fistula (UCF) development. Tunneled tunica vaginalis flap (TVF) is a well-described technique for the repair of UCF. We retrospectively reviewed all patients undergoing repeat repair of UCF after TIP repair from 2001 to 2005. Twelve boys underwent TVF repair at our institution for recurrent UCF. Fistulae ranged from distal penile to penoscrotal in location. Median surgical time was 45 minutes and no postoperative complications occurred. After a median follow-up of 32 months (range 16–48 months), no patient has yet had a recurrence of UCF. In conclusion, TVF repair is a successful technique for the treatment of UCF after previous failed repair. TVF is technically simple to perform and should be considered for treating UCF following TIP urethroplasty, particularly in a repeat surgical setting.