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Children with urinary fistula after hypospadias repair 35 cases


Scrotal dartos scrotum cut free, or open testicular sheath of the distal spermatic cord along its edge to the direction of the sheath and cut flap of sufficient length, can be tension-free coverage to the fistula region, do scrotal subcutaneous tunnel, the appropriate expansion through the tunnel will be transferred to the fistula testicular sheath area, will reset the scrotum testes, without a fixed, close scrotal incision, with the sheath covering the fistula, and then use 6-0 absorbable suture parallel to the longitudinal seam in the fistula hydrocele organizations around the mouth, only 4 to 6-pin can be fixed, stitched around the subcutaneous tissue and skin, exposed in 8F-IOF do more silicone tube stent side hole drainage of urine. I. 3 standard orthotopic urethral opening cure, voiding urethra, urination, fistula healing was cured. 2 Results 35 cases of inverted continuous suture to strengthen the urethral fistula after hypospadias patients, fistula 4mm in 16 patients, 14 cases were successful, 2 cases of failure, the success rate of 87.5%. 3 Discussion hypospadias fistula is the most common complications after surgery, many patients soon after surgery or after surgery to find urinary fistula, urinary fistula occurrence and development are affected by many factors. 4, J6 skin tender,[link widoczny dla zalogowanych], thin fascia is urethral fistula occurred after angioplasty of the potential factors. Edema, poor blood supply, infection and hematoma, impede the healing of the new urethra, distal urethra was blocked crust or necrotic material cause high pressure within the urethra during urination may be the proximal suture dehiscence,[link widoczny dla zalogowanych], suture final technical factors such as repeat , or absorption lines may be of poor quality, can lead to fistula formation. In addition to the pinhole size postoperative fistula may heal itself outside. Fistula repair surgery normally takes. The basic conditions of operation include: the distance over the last 6 months surgery, scar softening, organizational health; urethral fistula in particular, should be no scar stenosis,[link widoczny dla zalogowanych], or narrowing increased after repair, it is difficult urethral stent placement leads to failure; local non-inflammatory performance, no recent bladder,[link widoczny dla zalogowanych], urinary tract symptoms of acute infection; nearly 2 weeks without urethral dilatation, catheter insertion and other operations; if a large pseudo-urethral diverticulum should be disposed of J. There are many ways for fistula repair. Some studies that affect the urinary fistula repair surgery many factors: such as urethroplasty after fistula appearance time, the original surgery options, the original surgery and fistula surgery interval, urinary fistula location, size, quantity and fistula around the conditions. A study of the acceptance of children with urinary fistula repair surgery, they found the success rate with patients age, place stents and other factors unrelated to the original urethroplasty with a reasonable choice, but not with urinary fistula repair time was positively correlated with the number of J. Regardless of which method repair, we believe that the key to the success of urinary fistula repair is free good and sufficient blood supply to the flap and reliable multi-layer suture of the bladder of urine flow, and distal fistula with or without obstruction in the presence of urinary unobstructed drainage, is also a major factor. The choice of time to repair tissue damage in the operations carried out after complete healing. Because angiogenesis and inflammation or edema dissipated, to June when the general Pei Wen. Therefore, the general treatment of hypospadias at least 6 months after fistula repair can be conducted. In this paper, using a continuous inverted suture to enhance repair of hypospadias fistula after surgery, in which fistula 4mm l6 cases of patients, 14 cases were successful,[link widoczny dla zalogowanych], 2 cases of failure, the success rate of 87.5%. For continuous inverted suture strengthening, strengthening the continuous inverted suture can improve local tissue blood circulation, promote healing and reduce urinary fistula. This article uses the meat, membrane, or sheath reinforced the urethra, the skin and urinary tract more than a layer between the rich blood supply and tissue, reducing the incidence of urinary fistula. Membrane and sheath meat rich blood supply, covering the urethra is difficult to form after the fistula caused by ischemia and infection. Dartos or tunica vaginalis testis easily accessible, both sides of the sheath can be isolated easily, without causing damage to the testicles. Membrane or sheath can be used meat area, moved to the fistula at the easy to implement, less prone to reverse. Membrane sheath of free meat, its blood supply when properly stored to avoid damage, the state should cover the urethra without tension. Any failure of a urinary fistula repair surgery to re-repair will lead to greater difficulties, so need to fistula size, number, location and local conditions of strict control of surgical indications 0
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