Single-donor fibrin sealant for repair of urethrocutaneous fistulae following multiple hypospadias and epispadias repairs.

Abstract

PURPOSE:

To evaluate the efficacy of fibrin sealant for repair of urethrocutaneous fistula after multiple failed hypospadias and epispadias surgeries.

MATERIALS AND METHODS:

The study population comprised 11 boys (mean age 12.18 years) with history of hypospadias or epispadias and at least two failed fistula repair operations leading to recurrent urethrocutaneous fistula. During the operation, single-donor fibrin glue, either from the patient (7) or a parent (4), was applied over the suture lines and beneath the skin. A urethral catheter was kept in place for 7-10 days. Follow up ranged from 6 to 24 months (mean 12.63 months).

RESULTS:

Nine patients had an uneventful postoperative course. In one patient with a large fistula, partial wound dehiscence occurred. In another patient with complete hypospadias, hematoma formation caused skin dehiscence but the urethra remained intact. Both cases recovered after 6 months with no further intervention. No fistula recurrence was reported during follow up.

CONCLUSION:

Single-donor fibrin glue could be a useful adjunct to surgical management of patients after multiple failed attempts at hypospadias or epispadias fistula repair. Moreover, this product improves the safety margin regarding the risk of disease transmission.

• Authors: Abdol-Mohammad Kajbafzadeh, Hassan Abolghasemi, Peyman Eshghi, Farshid Alizadeh, Azadeh Elmi, Saman Shafaattalab, Seyedsaeid Dianat, Naser Amirizadeh, Mohammad Javad Mohseni
• Journal: Journal of pediatric urology (J Pediatr Urol) Vol. 7 Issue 4 Pg. 422-7 (Aug 2011) ISSN: 1873-4898 [Electronic] England
• PMID: 20634140 (Publication Type: Journal Article)
• Copyright: Copyright © 2010. Published by Elsevier Ltd.

Chemical References

• Fibrin Tissue Adhesive
• Tissue Adhesives

Topics

• Adolescent
• Child
• Dermatologic Surgical Procedures
• Epispadias (surgery)
• Fibrin Tissue Adhesive (therapeutic use)
• Follow-Up Studies
• Humans
• Hypospadias (surgery)
• Male
• Postoperative Complications (pathology, surgery)
• Reoperation (adverse effects)
• Skin (pathology)
• Tissue Adhesives (therapeutic use)
• Urethra (pathology, surgery)
• Urinary Fistula (etiology, pathology, surgery)