Abhinav Singh1*, Malika Singh2, Rohini Singh3 and RB Singh4
1Department of Burns, Plastic and Reconstructive Surgery, Mahatma Gandhi Medical College, Jaipur, India 2Department of GI Surgery, Amrita Institute of Medical Sciences (AIMS), Kerala, India 3Department of Dermatology, Mahatma Gandhi Medical College, Jaipur, India 4Department of Burns & Plastic Surgery, Postgraduate Institute of Medical Sciences (PGIMS), University of Health Sciences Rohtak (UHSR), IndiaFulltext PDF
Purpose: To assess feasibility and success of a sutureless, cost effective and time saving minimal invasive surgical technique for the treatment of Ultra-Micro Urethro-Cutaneous Fistulas (UMUCFs) measuring up to 1 mm or less in diameter. Aims and Objectives: To devise minimal invasive procedure for closure of Ultra-Micro Urethro- Cutaneous Fistulas (UMUCFs) measuring one millimeter or less in diameter. Material and Methods: Since 2006 to 2016, ten patients aged between 15 to 20 years reported in Hypospadias and VVFs Clinic with 6 months to one year history of leakage of urine either in the form of few drops (n=4) or a thin jet of urinary stream (n=6) through UCFs sized less or up to one millimeter in diameter located in distal penile shaft (n=8) and mid-penile shaft (n=2) having developed after hypospadiac urethroplasties. The tracts of the fistulas were approached indirectly through dartos-deep 5-millimeter incision given in the lateral coronal sulcus in 8 patients having UCFs in their distal penile shaft and through surgical scar in the mid-penile shaft of 2 patients having UCFs in mid-penile region. The fistula tracts were completely transected (tractotomy) after having them dissected circumferentially using blunt and sharp dissection by a pair of scissors passed through skin incision. Infant feeding tube was inserted across the urethra for continuous drainage of urinary bladder for 3 days. A snugly fitted circumferential dressing under moderate compression was applied to facilitate intimate contact of dissected tissues to prevent leakage and collection of urine in the surgical field. The UCFs associated with stricture, diverticulum, stones, hairs, metaplasia and the thin-walled attenuated UCFs were excluded from undergoing this surgical technique. Results: All the ten UCFs healed uneventfully and patients were discharged on 5th day of surgery. However, none of these patients reported in follow-ups after having been discharged. Conclusion: The innovation is technically least demanding, safe, cost and time effective and promotes healing of transected tracts of ultra-micro UCFs and the skin incisions without application of sutures (sutureless UCFs repair).
Urethro-Cutaneous Fistulas (UCFs); Ultra-Micro Urethro-Cutaneous Fistulas (UMUCFs); Sutureless; UCFs repair
Singh A, Singh M, Singh R, Singh RB. Sutureless Treatment of Ultra-Micro Urethro-Cutaneous Fistulas (UMUCFS): A Technical Innovation. J Surg Tech Proced. 2021;5(1):1046..