View source for Urethrocutaneous fistula

'''Urethrocutaneous fistula''' is a complication of [[circumcision]].<ref name="williams-kapilla1993">{{REFjournal
 |last=Williams
 |init=N
 |author-link=
 |last2=Kapilla
 |init2=L
 |author2-link=
 |etal=no
 |title=Complications of circumcision.
 |journal=Brit J Surg
 |location=
 |date=1993-10
 |volume=80
 |issue=10
 |pages=1231-6
 |url=http://www.cirp.org/library/complications/williams-kapila/
 |quote=
 |pubmedID=8242285
 |pubmedCID=
 |DOI=10.1002/bjs.1800801005
 |accessdate=2022-01-27
}}</ref> <ref name="krill2011">{{REFjournal
 |last=Krill
 |first=Aaron J.
 |init=
 |author-link=
 |last2=Palmer
 |first2=Lane S.
 |init2=
 |author2-link=
 |last3=Palmer
 |first3=Jeffrey S.
 |init3=
 |author3-link=
 |etal=
 |title=Complications of circumcision
 |trans-title=
 |language=
 |journal= ScientificWorldJournal
 |location=
 |date=2011-12-26
 |volume=11
 |issue=
 |article=
 |page=
 |pages=2458-68
 |url=https://www.hindawi.com/journals/tswj/2011/373829/
 |archived=
 |quote=
 |pubmedID=22235177
 |pubmedCID=3253617
 |DOI=https://doi.org/10.1100/2011/373829
 |accessdate=2022-01-27
}}</ref> It rarely, if ever, occurs in [[intact]] males. Urethrocutaneous fistula is an opening of the [[urethra]] on the ventral side of the [[penis]]. Ahmed et al. (1999) reported that fistula also occurs in areas where traditional circumcision is still practiced.<ref name="ahmed1999">{{REFjournal
 |last=Ahmed
 |first=
 |init=A
 |author-link=
 |last2=Mbibi
 |first2=
 |init2=NH
 |author2-link=
 |last3=Dawam
 |first3=
 |init3=D
 |author3-link=
 |last4=Kalawi
 |first4=
 |init4=GD
 |author4-link=
 |etal=no
 |title=Complications of traditional male circumcision
 |trans-title=
 |language=
 |journal=Ann Trop Paediatr
 |location=
 |date=1999-03-01
 |volume=19
 |issue=1
 |article=
 |page=113-7
 |pages=
 |url=http://www.cirp.org/library/complications/ahmed1/
 |archived=
 |quote=
 |pubmedID=10605531
 |pubmedCID=
 |DOI=10.1080/02724939992743 
 |accessdate=2022-01-27
}}</ref>

The human penis is made up of three columns of tissue: two corpora cavernosa lie next to each other on the dorsal side and one corpus spongiosum lies between them on the ventral side. The urethra passes through the corpus spongiosum near the ventral surface of the [[penis]] shaft. Occasionally, during a [[circumcision]] mishap, the urethra is opened on the ventral surface to create the urethrocutaneous fistula.

==Treatment==
Baskin et al. (1997) described surgical repair of urethrocutaneous fistula.

<blockquote>
In 8 patients urethrocutaneous fistulas located on the distal penile shaft or at the coronal margin were managed by splitting the glans and using a Mathieu style skin flap in 4 or vascularized penile skin flap in 4 to bridge the urethral defect. Three patients underwent repair of a hypospadiac deviated urethra secondary to partial glans amputation by 1 cm. of urethral mobilization and repositioning the meatus into a terminal position within the remaining glans tissue.<ref name-"baskin1997">{{REFjournal
 |last=Baskin
 |first=
 |init=LS
 |author-link=
 |last2=Canning
 |first2=
 |init2=DA
 |author2-link=
 |last3=Snyder
 |first3=
 |init3=HM
 |author3-link=
 |last4=Duckett, Jr.
 |first4=
 |init4=JW
 |author4-link=
 |etal=no
 |title=Surgical repair of urethral circumcision injuries
 |trans-title=
 |language=
 |journal=J Urol
 |location=
 |date=1997-12
 |volume=158
 |issue=6
 |article=
 |page=
 |pages=2269-71
 |url=http://www.cirp.org/library/complications/baskin/
 |archived=
 |quote=
 |pubmedID=9366374
 |pubmedCID=
 |DOI=10.1016/s0022-5347(01)68233-8 
 |accessdate=2022-01-27
}}</ref>
</blockquote>

==Case reports==
Limaye & Hancock (1968) reported a case in which the fistula near the site of the [[frenulum]] had been misdiagnosed as "[[hypospadias]]." The authors commented on the difficulty of repairing the fistula.<ref name="limaye1968">{{REFjournal
 |last=Limaye
 |first=
 |init=RD
 |author-link=
 |last2=Hancock
 |first2=
 |init2=RA
 |author2-link=
 |etal=no
 |title=Penile urethral fistula as a complication of circumcision
 |trans-title=
 |language=
 |journal=J. Pediatr
 |location=
 |date=1968-01
 |volume=71
 |issue=1
 |article=
 |page=
 |pages=105-6
 |url=http://www.cirp.org/library/complications/limaye/
 |archived=
 |quote=Urethral injury seems more likely to occur when there is [[bleeding]] from the frenum and an attempt is made to control it with a suture. A suture placed too deeply may strangulate a part of the urethral wall, thus leading to the formation of a fistula.
 |pubmedID=5634930
 |pubmedCID=
 |DOI=10.1016/s0022-3476(68)80410-x
 |accessdate=2022-01-27
}}</ref>

{{REF}}

[[Category:Education]]
[[Category:Circumcision complication]]
[[Category:Penile anatomy]]
[[Category:Medical term]]

[[de:Urethrokutane Fistel]]