Our Summary
This research paper discusses the results of a study that looked at how effective a certain method, using a tunica vaginalis graft, was in repairing a recurring issue known as urethrocutaneous fistula in children. This issue is essentially a hole that develops between the urethra (the tube that carries urine from the bladder out of the body) and the skin. The study involved 45 children who had already had one unsuccessful repair, and they were given the graft repair a minimum of 6 months after their initial repair.
The children were monitored closely for a month after the procedure, then monthly for 6 more months, and yearly after that. They were evaluated through medical history and physical examinations, including observing how they urinated. If needed, urine tests were also performed.
The results showed that the graft repair was successful in 95.6% of the children, with only 4.4% having the problem recur. Those who experienced a recurrence had further repairs after 6 months. All patients were reported to have a good cosmetic appearance of the penis without any complications.
In other words, using a tunica vaginalis graft as a second layer in the repair of a recurring urethrocutaneous fistula is a simple, fast, and effective procedure.
FAQs
- What is a urethrocutaneous fistula and how is it treated?
- How successful was the use of a tunica vaginalis graft in repairing recurring urethrocutaneous fistula?
- What is the follow-up care for children who underwent the graft repair procedure?
Doctor’s Tip
One helpful tip a doctor might give to a patient undergoing hypospadias repair is to follow post-operative care instructions carefully. This may include keeping the surgical site clean and dry, avoiding strenuous activities or heavy lifting, and taking any prescribed medications as directed. It is also important to attend all follow-up appointments to ensure proper healing and address any concerns that may arise. By following these instructions, patients can help optimize their recovery and minimize the risk of complications.
Suitable For
Patients who are typically recommended hypospadias repair include children with a urethrocutaneous fistula that has not been successfully repaired with previous procedures. This may include children who have had complications or recurrence of the issue after initial repairs. In these cases, using a tunica vaginalis graft as a second layer in the repair may be a recommended treatment option.
Timeline
Before the hypospadias repair, the patient likely experiences difficulty with urination and may have a visible hole or abnormal opening on the underside of the penis. They may have already undergone a previous repair that was unsuccessful.
After the hypospadias repair using the tunica vaginalis graft, the patient undergoes close monitoring for a month post-procedure, followed by monthly check-ups for 6 months and then yearly evaluations. The patient’s medical history and physical examinations are closely observed, including monitoring their urination patterns and conducting urine tests if necessary.
The results show that the graft repair is successful in the majority of cases, with a low recurrence rate. Patients who do experience a recurrence can undergo further repairs after 6 months. Overall, the procedure is reported to have good cosmetic outcomes and no complications.
What to Ask Your Doctor
Some questions a patient should ask their doctor about hypospadias repair include:
- What is hypospadias and why do I need surgery to repair it?
- What are the risks and potential complications associated with hypospadias repair surgery?
- How experienced are you in performing hypospadias repair surgery?
- What is the success rate of the specific surgical technique you plan to use for my repair?
- What is the expected recovery time and what post-operative care will be required?
- Will I need additional surgeries or treatments in the future?
- How will the appearance and function of my penis be affected after the surgery?
- What can I do to help ensure a successful outcome and minimize the risk of complications?
- Are there any long-term effects or considerations I should be aware of?
- Are there any alternative treatment options available for my condition?
Reference
Authors: Aldaqadossi HA, Eladawy M, Shaker H, Kotb Y, Azazy S. Journal: Int J Urol. 2020 Sep;27(9):726-730. doi: 10.1111/iju.14287. Epub 2020 Jun 17. PMID: 32557894