Journal of pediatric urology · 2026
Parafistulous penile skin flap: A modified technique for repair of urethrocutaneous fistulas post hypospadias repair in children.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Aboelnasr Mahmoud, Hindawy Mohammed Abdallah, Salih Elsayed Mohamed, El-Guoshy Farouk Ismail, Emadeldin Mohamed, Elatreisy Adel
Аннотация
PURPOSE: To evaluate the efficacy of our novel technique utilizing a para-fistulous penile skin flap to repair urethrocutaneous fistulas in children.
METHODS: A Prospective case series study included repairing 69 urethrocutaneous fistulas with our technique. It consists of a para-fistulous penile skin flap, with a second dartos layer obtained with a specific approach and a third full-thickness skin layer. Concomitant Meatoplasty was performed for associated meatal stenosis. Surgical success is defined as normal voiding without fistula recurrence. Both univariate and multivariate analyses were utilized to assess predictors of fistula recurrence.
RESULTS: The mean age ±SD was 6.5 ± 4.8 years, and the mean fistula size was 6.5 ± 3.9 mm. A total of 40 fistulas (58 %) measured ≥5 mm, while 29 (42 %) were <5 mm. Sixty cases (93.8 %) were diagnosed with a single fistula, while four patients (6.3 %) had multiple fistulas. Additionally, 11 cases (17.2 %) were associated with meatal stenosis. The mean operative time was 56.8 ± 6.8 min, and the mean follow-up period was 11.75 ± 5 months. Four patients (6.2 %) experienced low-grade complications. Sixty-three cases (91.3 %) achieved successful fistula repair, and the success rate for large (>5 mm) and multiple fistulas was 95 % and 88.9 %, respectively. On univariate analysis, Multiple Previous hypospadias repairs, preoperative meatal stenosis, postoperative wound infection, and superficial skin necrosis were significantly associated with fistula recurrence (P < 0.05); however, multivariate regression analysis showed a significant correlation with preoperative meatal stenosis (p = 0.003) and superficial skin necrosis (p = 0.045).
CONCLUSION: This study demonstrates the efficacy of our novel Para-fistulous Penile Skin Flap technique in repairing urethrocutaneous fistulas in pediatrics, achieving good outcomes for both large and multiple fistulas. Preoperative meatal stenosis and postoperative superficial skin necrosis were the independent predictors of fistula recurrence.
METHODS: A Prospective case series study included repairing 69 urethrocutaneous fistulas with our technique. It consists of a para-fistulous penile skin flap, with a second dartos layer obtained with a specific approach and a third full-thickness skin layer. Concomitant Meatoplasty was performed for associated meatal stenosis. Surgical success is defined as normal voiding without fistula recurrence. Both univariate and multivariate analyses were utilized to assess predictors of fistula recurrence.
RESULTS: The mean age ±SD was 6.5 ± 4.8 years, and the mean fistula size was 6.5 ± 3.9 mm. A total of 40 fistulas (58 %) measured ≥5 mm, while 29 (42 %) were <5 mm. Sixty cases (93.8 %) were diagnosed with a single fistula, while four patients (6.3 %) had multiple fistulas. Additionally, 11 cases (17.2 %) were associated with meatal stenosis. The mean operative time was 56.8 ± 6.8 min, and the mean follow-up period was 11.75 ± 5 months. Four patients (6.2 %) experienced low-grade complications. Sixty-three cases (91.3 %) achieved successful fistula repair, and the success rate for large (>5 mm) and multiple fistulas was 95 % and 88.9 %, respectively. On univariate analysis, Multiple Previous hypospadias repairs, preoperative meatal stenosis, postoperative wound infection, and superficial skin necrosis were significantly associated with fistula recurrence (P < 0.05); however, multivariate regression analysis showed a significant correlation with preoperative meatal stenosis (p = 0.003) and superficial skin necrosis (p = 0.045).
CONCLUSION: This study demonstrates the efficacy of our novel Para-fistulous Penile Skin Flap technique in repairing urethrocutaneous fistulas in pediatrics, achieving good outcomes for both large and multiple fistulas. Preoperative meatal stenosis and postoperative superficial skin necrosis were the independent predictors of fistula recurrence.