Gite Venkat A, Patil Saurabh R, Bote Sachin M, Siddiqui Mohd Ayub Karam Nabi, Nikose Jayant V, Kandi Anitha J
Department of Urology, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, India.
Urol Int. 2017;99(1):29-35. doi: 10.1159/000455159. Epub 2017 Jan 25.
Urethrocutaneous fistula, which occurs after hypospadias surgery, is often a baffling problem and its treatment is challenging. The study aimed to evaluate the results of the simple procedure (Durham Smith vest-over-pant technique) for this complex problem (post-hypospadias repair fistula).
During the period from 2011 to 2015, 20 patients with post-hypospadias repair fistulas underwent Durham Smith repair. Common age group was between 5 and 12 years. Site wise distribution of fistula was coronal 2 (10%), distal penile 7 (35%), mid-penile 7 (35%), and proximal-penile 4 (20%). Out of 20 patients, 15 had fistula of size <5 mm (75%) and 5 patients had fistula of size >5 mm (25%). All cases were repaired with Durham Smith vest-over-pant technique by a single surgeon. In case of multiple fistulas adjacent to each other, all fistulas were joined to form single fistula and repaired.
We have successfully repaired all post-hypospadias surgery urethrocutaneous fistulas using the technique described by Durham Smith with 100% success rate.
Durham Smith vest-over-pant technique is a simple solution for a complex problem (post hypospadias surgery penile fistulas) in properly selected patients.
尿道下裂手术后发生的尿道皮肤瘘常常是一个棘手的问题，其治疗具有挑战性。本研究旨在评估针对这一复杂问题（尿道下裂修复术后瘘）的简单手术方法（达勒姆·史密斯背心式修补术）的效果。
在2011年至2015年期间，20例尿道下裂修复术后瘘患者接受了达勒姆·史密斯修补术。常见年龄组为5至12岁。瘘的部位分布为冠状沟2例（10%）、阴茎远端7例（35%）、阴茎中段7例（35%）、阴茎近端4例（20%）。20例患者中，15例瘘口大小<5毫米（75%），5例瘘口大小>5毫米（25%）。所有病例均由一名外科医生采用达勒姆·史密斯背心式修补术进行修复。若存在多个相邻瘘口，则将所有瘘口合并成一个瘘口并进行修复。
我们使用达勒姆·史密斯描述的技术成功修复了所有尿道下裂手术后的尿道皮肤瘘，成功率达100%。
对于经过恰当选择的患者，达勒姆·史密斯背心式修补术是解决复杂问题（尿道下裂手术后阴茎瘘）的一种简单方法。
