Sub coronal fistulae

Dr. Anil Takvani

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Spotter

19 Mar 2023 09:18:09 PM

A case: Diagnosis & ...

10 Mar 2023 08:34:24 AM

Most common site for fistulae formation in distal Hypospadias is sub coronal.

I am posting image of fistulae following distal Hypospadias repair.

Child is 2 years old, was operated before 8 months.

How will you tackle this fistula? Glans is good...

Thanks

Comments(4)

Amilal Bhat
05 Feb 2020 12:20:25 PM

mobilize the fistulous track as well as glandular wings. Close fistula the covet with ventral dartos then suture the glandular wing over that
Amilal Bhat
05 Feb 2020 12:31:09 PM

If glandular urethra narrow then lay open the distal urethra, dorsal iinlay tubularize urethra cover with dartos n glanuloplasty.
Dr. Anil Takvani
05 Feb 2020 06:05:45 PM

Fistulous tract was cut circumferencialy . Incision was extended as shown in image.
Ventral dartos was separated from skin + dartos flap.
Fistula was closed with three subcuticular stitches.
Fistulous closure was covered with separated dartos... This second layer was much better than first one.
Skin was suture as third layer extending beyond first two layers.
Glans was not disturbed as it is good.
Urethra was allowing 8f feeding tube easily...
Thanks
Uday Sankar Chatterjee
16 Feb 2020 09:22:33 AM

I think, this fistula is a STF (suture track fistula).

I do 'needling' by surface anaesthesia with prilocaine oint as office/day care procedure. Keep cath for 5-7 days.

Needling is ablation of epithelium of STF with tip of 24G needle.