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.