Our Summary

Hypospadias is a common birth defect where the opening of the urethra is on the underside of the penis instead of at the tip. After surgery to correct this, some patients develop a complication called a urethrocutaneous fistula (UCF), which is a small hole that can cause urine to leak out.

In this study, researchers looked at the results of a new surgical technique called PATIO (preserve the tract and turn it inside out) in treating UCF, and compared it to the standard repair method. They did this by looking back at medical records of pediatric patients who had UCF repair surgery between 2005 and 2018.

Out of 586 patients who had the initial hypospadias surgery, 44 developed UCF that needed further repair. The researchers found that the PATIO technique was more successful than the standard technique - 81% of PATIO repairs were successful, compared to 44% of standard repairs. When the PATIO technique was used after a standard repair, it was successful 100% of the time.

The researchers concluded that the PATIO technique could be a better way to repair UCF and reduce the risk of the problem coming back. However, they noted that more research is needed, particularly long-term follow up of patients who have had the PATIO technique, to confirm these results. The study was limited by the small number of cases and the fact that it looked back at patient records rather than conducting a trial.

FAQs

  1. What is hypospadias and how is it typically corrected?
  2. What is the PATIO technique and how does it compare to the standard method in treating urethrocutaneous fistula (UCF)?
  3. What are the limitations of the study on the PATIO technique and what further research is needed?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to follow post-operative care instructions carefully to reduce the risk of complications such as a urethrocutaneous fistula. It is also important to attend follow-up appointments with your healthcare provider to monitor healing and address any concerns promptly. Discussing the possibility of using the PATIO technique for UCF repair with your healthcare provider may also be beneficial, as it has shown promising results in this study.

Suitable For

Patients who are typically recommended hypospadias repair are infants or children born with hypospadias, where the opening of the urethra is not at the tip of the penis. Additionally, patients who develop complications such as a urethrocutaneous fistula (UCF) after initial hypospadias repair surgery may also be recommended for further repair. In particular, patients with UCF may benefit from the PATIO (preserve the tract and turn it inside out) technique, as it has been shown to be more successful in repairing UCF compared to the standard repair method.

Timeline

Overall, the timeline of a patient before and after hypospadias repair would involve the initial surgery to correct the birth defect, followed by potential complications such as a urethrocutaneous fistula. If a patient develops a UCF, they may undergo further repair surgery using techniques such as PATIO. The study discussed found that the PATIO technique had higher success rates compared to the standard repair method, but more research is needed to confirm these results and assess long-term outcomes.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hypospadias repair, specifically regarding the possibility of developing a urethrocutaneous fistula (UCF) and the use of the PATIO technique, include:

  1. What is the likelihood of developing a UCF after hypospadias repair surgery?
  2. What are the symptoms of a UCF and how is it typically diagnosed?
  3. What is the standard method for repairing a UCF and how successful is it?
  4. Can the PATIO technique be used to repair a UCF and how does it compare to the standard technique in terms of success rates?
  5. What are the potential risks and complications associated with the PATIO technique?
  6. Are there any long-term consequences or concerns to consider with the PATIO technique?
  7. What is the recovery process like after undergoing UCF repair surgery with the PATIO technique?
  8. Are there any lifestyle changes or precautions that need to be taken after UCF repair surgery?
  9. How often will follow-up appointments be needed to monitor the success of the repair?
  10. Are there any additional resources or support groups available for individuals undergoing UCF repair surgery?

Reference

Authors: Singh J. Journal: J Pediatr Urol. 2022 Feb;18(1):60.e1-60.e7. doi: 10.1016/j.jpurol.2021.11.014. Epub 2021 Dec 1. PMID: 34922832