Repair of urethrocutaneous fistulas by double skin flap. Report of 32 cases.

Objectives : Urethrocutaneous fistula constitutes the main complication of urethroplasty for hypospadias. The frequency of this complication ranges fr om 12 to 90%. The multiplicity of fistula closure techniques, reflects the difficulty involved in repairing these lesions. The authors evaluated fistu la repair by a double pedicle skin flap according to the Wise technique. Material and Methods : 32 patients were treated: 18 had already undergone 3 4 attempted repairs of urethrocutaneous fistulas complicating urethroplasti es (9 Mathieu, 17 Duplay and 6 Leveuf) for anterior penile (9), middle peni le (14) and penoscrotal hypospadias (9). In 14 cases, the Wise technique wa s the first procedure used to repair the fistula. Results. The authors obtained 29 successes. The 3 failures concerned fistul as after Duplay urethroplasties to correct penoscrotal hypospadias. The ove rall success rate of this technique in our series (90%) was therefore close to that reported by Wise (5 out of 6 successes), who described this techni que in 1977. Conclusion : The Wise technique is a good technique for repair of large, re current urethrocutaneous fistulas after several attempts of repair.