Farooq Abdullah, Waheed Akhtar, Muhammad Imran, Inayatur Rahman.
Frequency of Urethro-cutaneous Fistula & Meatal Stenosis Post-Snodgross Repair with Dartos Flap for Hypospadias in Children.
Ophthalmol Update Jan ;16(4):904-7.

Objective: The aim is to determine the frequency of Urethro-cutaneous fistula and Meatal Stenosis over a period of one year following Snodgrass Repair for Anterior Hypospadias in children. Methodology: This prospective study was conducted in Pediatric Surgery Unit, Khyber Teaching Hospital, Peshawar, over a period of one year from January 2017 to December 2017. Patients with Anterior hypospadias (distal penile, subcoronal, coronal) aged between 18 months to 12 years were included. Patients with previous history of hypospadias surgery were excluded from the study. Procedure was performed under general anesthesia and modified Snodgrass repair was performed. The neourethra was tubularised over 6-8Fr feeding tube used as a catheter. Tube was removed on 7th post-operative day in all cases and presence of fistula or meatal stenosis, if any, was recorded. Initial follow up was done in OPD after 1 month. The patients were then re-evaluated after 3 months to assess any of the two complications under question. Results: TIP repair was performed in 63 patients during this study. Urethro-cutaneous fistula occurred in 7(11.11%) out of 63 patients while meatal stenosis was present in 4(6.3%). None of the patients had total disruption or wound infection. Conclusion: Despite occurrence of fistula and meatal stenosis, TIP repair is a suitable method of treating patients with anterior hypospadias with low rates of complications. It has good aesthetic results and can be done successfully in children who have already been circumcised.

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