De-epithelialized scrotal flap in repair of urethrocutaneous fistula and hypospadias

Eight cases of closure of urethrocutaneous fistula and 15 cases of urethroplasty for hypospadias are reviewed. Most of the fistulas were present in the penoscrotal level. Fistula and hypospadias opening were closed by re-enforcement using a de-epithelialized scrotal skin flap. Of 8 patients with fistula, there was no recurrence, and 3 procedures were performed without urinary diversion or urethral stent. Of 15 patients with hypospadias, there was no fistula formation in the original urethral opening area but a fistula distal to the original urethral opening developed in 3 patients. This technique is satisfactory in repairing complicated as well as noncomplicated urethrocutaneous fistula and can be done without urinary diversion or urethral stent. It appears to be useful in reducing fistula formation following urethroplasty in hypospadias or urethral fistula repair.