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Urethro-cutaneous Fistula After Hypospadia Repair: A Single Institution Study

Tim Jumbi,1 Swaleh Shahbal,1 Robert Mugo,1 Francis Osawa,1 Peter Mwika,1 Joel Lessan2
1 University of Nairobi
2 Kenyatta National Hospital
Correspondence to: Dr Jumbi Tim, PO Box 1059–00618, Ruaraka, Nairobi;


Urethro-cutaneous fistula (UCF) is one of the most frequently seen complications of hypospadias surgery requiring re-operation; it occurs with an incidence of between 4% and 28%. Risk factors associated with the development of UCF can be classified as preoperative, intraoperative or postoperative. The aim of this study was to determine the association of peri-operative risk factors and the development of urethrocutaneous fistula after hypospadias repair. A retrospective review of patients who had undergone hypospadias repair at Kenyatta National Hospital between 2013 and 2017 was conducted. 114 patient records were retrieved. The incidence of UCF was 47%. Risk factors that were significantly associated with UCF are hypospadias type (p=0.028), lack of a protective intermediate layer (p=0.002), and presence of postoperative complications (p=0.001). Age at surgery, suture material, type of repair and use of catheter/stents were not significant factors. Multivariate analysis showed wound infection and meatal stenosis as the most significant factors associated with UCF development.

Key words: Hypospadias, Urethro-cutaneous fistula, Risk factors, Wound infection, Meatal stenosis

Ann Afr Surg. 2019; 16(2):59–63


Conflicts of Interest: None

Funding: None

© 2019 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

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