Kautsar M I A, Mustafa A
Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia.
Urology Department, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.
Int J Surg Case Rep. 2025 May;130:111255. doi: 10.1016/j.ijscr.2025.111255. Epub 2025 Apr 4.
Circumcision, a globally prevalent surgical procedure, carries the risk of complications, including the rare occurrence of urethrocutaneous fistula (UCF). Treatment options for UCF range from conservative management to complex surgical repairs, such as the Cecil-Culp procedure. This study aims to evaluate the efficacy of the Cecil-Culp procedure in repairing UCF following circumcision.
A 2-year-old boy with a history of circumcision developed UCF and loss of penile skin as a complication, leading to surgical repair using conventional methods and subsequently an inguinal flap and tunica vaginalis flap procedure due to insufficient skin. Despite these interventions, the patient showed poor healing and the UCF persisted. Consequently, 6 months later, re-surgery was planned utilizing the Cecil-Culp procedure. Postoperatively, the patient demonstrated favorable outcomes in surgical wound healing, with no recurrence of the UCF.
UCF is a rare but significant complication of circumcision. Treatment strategies depend on the size, location, and severity of the fistula, ranging from primary closure to complex flap-based repairs. In this case, after failed conventional methods, the Cecil-Culp technique was employed. This two-stage procedure, which involves temporarily burying the urethra in the scrotum, provided adequate tissue coverage and resulted in successful healing with no recurrence. Long-term follow-up is recommended to assess potential complications.
The Cecil-Culp procedure proved to be an effective surgical option for UCF repair following circumcision, particularly in cases with inadequate penile skin. Long-term monitoring remains essential to evaluate possible complications.
包皮环切术是一种全球普遍施行的外科手术，存在并发症风险，包括罕见的尿道皮肤瘘（UCF）。UCF的治疗选择范围从保守处理到复杂的手术修复，如塞西尔 - 卡尔普手术。本研究旨在评估塞西尔 - 卡尔普手术修复包皮环切术后UCF的疗效。
一名有包皮环切术病史的2岁男孩出现UCF并伴有阴茎皮肤缺失并发症，最初采用传统方法进行手术修复，随后因皮肤不足进行了腹股沟皮瓣和鞘膜瓣手术。尽管采取了这些干预措施，患者愈合不佳，UCF持续存在。因此，6个月后计划采用塞西尔 - 卡尔普手术再次手术。术后，患者手术伤口愈合良好，UCF未复发。
UCF是包皮环切术罕见但严重的并发症。治疗策略取决于瘘管的大小、位置和严重程度，从一期缝合到基于皮瓣的复杂修复。在本病例中，传统方法失败后采用了塞西尔 - 卡尔普技术。这个两阶段的手术包括暂时将尿道埋入阴囊，提供了足够的组织覆盖，实现了成功愈合且无复发。建议进行长期随访以评估潜在并发症。
塞西尔 - 卡尔普手术被证明是修复包皮环切术后UCF的有效手术选择，特别是在阴茎皮肤不足的情况下。长期监测对于评估可能的并发症仍然至关重要。
