Chtourou M, Attyaoui F, Ben Younes A, Rekik H, Horchani A
Service d'Urologie, Hôpital La Rabta, Tunis.
Prog Urol. 2000 Apr;10(2):261-4.
Urethro-cutaneous fistula constitutes the main complication of urethroplasty for hypospadias. The frequency of this complication ranges from 12 to 90%. The multiplicity of fistula closure techniques, reflects the difficulty involved in repairing these lesions. The authors evaluated fistula repair by a double pedicle skin flap according to the Wise technique.
32 patients were treated: 18 had already undergone 34 attempted repairs of urethro-cutaneous fistulas complicating urethroplasties (9 Mathieu, 17 Duplay and 6 Leveuf) for anterior penile (9), middle penile (14) and penoscrotal hypospadias (9). In 14 cases, the Wise technique was the first procedure used to repair the fistula.
The authors obtained 29 successes. The 3 failures concerned fistulas after Duplay urethroplasties to correct penoscrotal hypospadias. The overall 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 technique in 1977.
The Wise technique is a good technique for repair of large, recurrent urethro-cutaneous fistulas after several attempts of repair.