Basharat Ali Khan, Muhammad Ali Shah, Faraz Basharat Khan


Background: Hypospadias is one of the most common congenital anomalies of the male
newborns affecting 1 in 300. Urethral meatus lies ectopically on the ventral surface of penis
proximal to its normal position. There is defective development of urethral spongiosum and
ventral prepuce. Various degrees of chordee may be associated. Objective of the study was to
study the incidence of urethrocutaneous fistula formation after hypospadias repair employing two
different suturing techniques. This Prospective Randomised Descriptive Clinical Trial was
conducted in Department of Surgery, Fauji Foundation Hospital, Rawalpindi and Basharat
Hospital, Rawalpindi, during a period of five years from January 2005 till December, 2009.
Methods: A prospective study of 100 patients of glanular/penile hypospadias requiring repair was
completed from January, 2005 till December, 2009. Fifty of these patients had urethral tube
reconstruction using conventional over and over continuous suturing technique (Group-1). In
another group of fifty patients continuous inverting sutures (Connel technique) commonly used in
intestinal anastomosis was employed (Group-2). Polyglycolic acid sutures 4/0 to 6/0 as
appropriate were used for all the repairs in both the groups by the same surgeon. Results: Six
(12%) urethrocutaneous fistulas formed in the Group-1 of fifty patients with over and over
continuous suturing as compared to 4 (8%) in Group- II with equal number of patients where
inverting suture technique was used. Conclusion: Inverting sutures reduce the incidence of
urethrocutaneous fistula formation in hypospadias repair.
Keywords: hypospadias, urethroplasty, urethrocutaneous fistula

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