Our Summary

Hypospadias is a common birth defect in boys where the opening of the urethra (the tube that carries urine from the bladder to the outside of the body) is not located at the tip of the penis. Sometimes, after surgery to correct this, a hole can form between the urethra and the skin, which is known as a urethrocutaneous fistula.

This study from Indonesia aimed to identify the risk factors that might contribute to the formation of this hole after hypospadias repair surgery. Researchers looked at data from 591 cases in 12 hospitals across 9 cities in Indonesia in 2018.

The study found that the patient’s age and the size of a tube (or splint) used during surgery were significant risk factors. Older patients and larger splint sizes increased the risk of a hole forming after surgery.

Interestingly, the study also found that the decision not to perform a procedure called a cystostomy during the repair surgery increased the risk of a hole forming. A cystostomy is a surgical procedure that creates an opening in the bladder to allow urine to exit the body.

So, in simple terms, older boys and those who had larger splints used during their hypospadias surgery were more likely to develop a hole between the urethra and the skin afterwards. Also, not performing a cystostomy during the surgery increased this risk.

FAQs

  1. What is a urethrocutaneous fistula?
  2. What factors increase the risk of a hole forming after hypospadias repair surgery?
  3. What is a cystostomy and how does it impact the risk of developing a urethrocutaneous fistula after hypospadias repair surgery?

Doctor’s Tip

Therefore, it is important for doctors to inform patients and their families about the potential risks associated with hypospadias repair surgery, including the possibility of developing a urethrocutaneous fistula. It is also important for doctors to consider the patient’s age, splint size, and the need for a cystostomy during surgery to minimize the risk of complications. Patients should follow post-operative care instructions carefully and follow up with their doctor regularly to monitor for any potential issues.

Suitable For

Therefore, patients who are recommended for hypospadias repair surgery are typically young boys with this birth defect. It is important for healthcare providers to consider the patient’s age, the size of the splint used during surgery, and the need for a cystostomy in order to minimize the risk of complications such as the formation of a urethrocutaneous fistula.

Timeline

Before hypospadias repair:

  • Diagnosis of hypospadias at birth or during routine check-ups
  • Consultation with a pediatric urologist to discuss treatment options
  • Pre-operative evaluations and tests to assess the severity of the condition and overall health
  • Surgery scheduled and preparation for the procedure

After hypospadias repair:

  • Recovery period following surgery, including pain management and wound care
  • Follow-up appointments with the surgeon to monitor healing and address any complications
  • Possible need for catheterization to assist with urinary function
  • Long-term follow-up to monitor for any potential complications, such as urethrocutaneous fistula formation
  • Continuation of regular check-ups to ensure proper growth and development of the penis

What to Ask Your Doctor

Some questions a patient should ask their doctor about hypospadias repair include:

  1. What are the potential risks and complications associated with hypospadias repair surgery?
  2. How will the surgery be performed and what is the expected outcome?
  3. What is the likelihood of developing a urethrocutaneous fistula after surgery?
  4. Will a cystostomy be performed during the surgery, and if not, why?
  5. What factors can increase the risk of developing a hole between the urethra and the skin after surgery?
  6. How will post-operative care be managed to prevent complications?
  7. What is the expected recovery time and follow-up care needed after surgery?
  8. Are there any long-term effects or considerations to be aware of after hypospadias repair surgery?
  9. Are there any lifestyle changes or precautions that should be taken post-surgery?
  10. What are the success rates of hypospadias repair surgery, and what can be done if complications arise?

Reference

Authors: Duarsa GWK, Tirtayasa PMW, Daryanto B, Nurhadi P, Renaldo J, Tarmono, Utomo T, Yuri P, Siregar S, Wahyudi I, Situmorang GR, Ansharullah Palinrungi MA, Hutasoit YI, Hutahaean AYA, Zulfiqar Y, Sigumonrong YH, Mirza H, Rodjani A, Kloping YP. Journal: J Pediatr Urol. 2020 Jun;16(3):317.e1-317.e6. doi: 10.1016/j.jpurol.2020.04.011. Epub 2020 Apr 19. PMID: 32360223