Repair of large urethrocutaneous fistula with dartos-based flip flap: A study of 23 cases

The commonest complication of hypospadias repair is occurrence of urethrocutaneous fistulae. These fistulae may be caused by a variety of factors and occur in different sizes at various sites of the previous repair. Small fistulae are easier to close with local tissue and flaps but larger fistulae which are 4 mm or more in size are difficult to close because of the paucity of available tissues and chances of recurrence. A variety of methods have been described in the literature for the repair of urethrocutaneous fistulae with variable results. In this study of 23 cases, we have successfully repaired large urethrocutaneous fistulae using dartos-based flip flaps for their closure in the period from June 2001 to May 2006. These flaps can cover any fistulae from the penoscrotal region to the distal penile shaft. Dartos-based flip flaps are robust and vascularized and provide watertight closure and at the same time they are easy to elevate and leave no residual donor site morbidity.