OBJECTIVES: • To evaluate urethrocutaneous fistula repair after urethroplasty using n-butyl cyanoacrylate (NBCA) in an outpatient setting. • To compare results of application of NBCA in 'early' and long-standing fistulae. PATIENTS AND METHODS: • From January 2003 to December 2006, 13 children (mean age 36 months) were treated in our Outpatient Department for urethrocutaneous fistula, which occurred after hypospadias repair. • We analysed the data dividing the patients in two groups: group A comprised six children (mean age 22.6 months) that developed a fistula within 2-3 days of catheter removal after urethroplasty ('early' fistula) and group B comprised seven children (mean age 42.6 months) with long-standing fistulae. • In all patients, a multilayer of NBCA was applied, attaching the edges of the fistula taking care to perform a scarification of the edges of the fistula in patients in group B before the application of the glue. RESULTS: • Four patients in group A and three patients in group B had definitive fistula repair (seven of 13), and six of the 13 had fistula recurrence. • Fistulae of ≤ 2 mm were more easily repaired than fistulae of > 2 mm (five of seven vs two of six). • Fistulae that tended to recover were those that responded to the first applications. CONCLUSIONS: • In this experience the use of NBCA as a minimally invasive treatment for fistula repair gave good results for repairing fistulae. • These preliminary results encourage the use of NBCA as a first non-surgical attempt to repair urethrocutaneous fistulae especially if the fistula is ≤2 mm. • The failure of this procedure does not compromise a possible subsequent surgical repair.
OBJECTIVES: • To evaluate urethrocutaneous fistula repair after urethroplasty using n-butyl cyanoacrylate (NBCA) in an outpatient setting. • To compare results of application of NBCA in 'early' and long-standing fistulae. PATIENTS AND METHODS: • From January 2003 to December 2006, 13 children (mean age 36 months) were treated in our Outpatient Department for urethrocutaneous fistula, which occurred after hypospadias repair. • We analysed the data dividing the patients in two groups: group A comprised six children (mean age 22.6 months) that developed a fistula within 2-3 days of catheter removal after urethroplasty ('early' fistula) and group B comprised seven children (mean age 42.6 months) with long-standing fistulae. • In all patients, a multilayer of NBCA was applied, attaching the edges of the fistula taking care to perform a scarification of the edges of the fistula in patients in group B before the application of the glue. RESULTS: • Four patients in group A and three patients in group B had definitive fistula repair (seven of 13), and six of the 13 had fistula recurrence. • Fistulae of ≤ 2 mm were more easily repaired than fistulae of > 2 mm (five of seven vs two of six). • Fistulae that tended to recover were those that responded to the first applications. CONCLUSIONS: • In this experience the use of NBCA as a minimally invasive treatment for fistula repair gave good results for repairing fistulae. • These preliminary results encourage the use of NBCA as a first non-surgical attempt to repair urethrocutaneous fistulae especially if the fistula is ≤2 mm. • The failure of this procedure does not compromise a possible subsequent surgical repair.
Authors: Gabriela Ambriz-González; Pedro Aguirre-Ramirez; José Manuel García-de León; Francisco Javier León-Frutos; Sergio Adrián Montero-Cruz; Xóchitl Trujillo; Clotilde Fuentes-Orozco; Michel Dassaejv Macías-Amezcua; Andrea del Socorro Álvarez-Villaseñor; Ana Olivia Cortés-Flores; Mariana Chávez-Tostado; Alejandro González-Ojeda Journal: BMC Urol Date: 2014-11-21 Impact factor: 2.264