Urethrocutaneous fistula
Urethrocutaneous fistula is a complication of circumcision.[1] [2] 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) report that fistula also occurs in areas where traditional circumcision is still practiced.[3]
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. described surgical repair of urethrocutaneous fistula.
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.[4]
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.[5]
References
- ↑
Williams N, Kapilla L. Complications of circumcision.. Brit J Surg. October 1993; 80(10): 1231-6. PMID. DOI. Retrieved 27 January 2022.
- ↑ Krill, Aaron J., Palmer, Lane S., Palmer, Jeffrey S.. Complications of circumcision. ScientificWorldJournal. 26 December 2011; 11: 2458-68. PMID. PMC. DOI. Retrieved 27 January 2022.
- ↑ Ahmed A, Mbibi NH, Dawam D, Kalawi GD. Complications of traditional male circumcision. Ann Trop Paediatr. 1 March 1999; 19(1): 113-7. PMID. DOI. Retrieved 27 January 2022.
- ↑ Baskin LS, Canning DA, Snyder HM, Duckett, Jr. JW. Surgical repair of urethral circumcision injuries. J Urol. December 1997; 158(6): 2269-71. PMID. DOI. Retrieved 27 January 2022.
- ↑ Limaye RD, Hancock RA. Penile urethral fistual as a complication of circumcision. J. Pediatr. January 1968; 71(1): 105-6. PMID. DOI. Retrieved 27 January 2022.
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.
