Incidence of urehtrocutaneous fistula formation during the first three postoperative months period of hypospadias reconstruction surgeries

Background and objectives: Urethrocutaneous fistula is one of the most frequent complications of hypospadias reconstructive surgeries. This study aimed to find the rate of fistula development following different types of reconstructive surgeries and their risk factors. Method: This study was conducted at Hawler teaching hospital, Rizgary teaching hospital, and Zheen international hospital in Erbil – Iraq from September 2020 to March 2021. A total number of 39 patients who underwent single-step surgery for reconstruction of hypospadias were included in this study and they were followed up for the first three months postoperatively for post-operative complications especially urethrocutaneuos fistula development. Results: Four patients out of thirty-nine developed urethral-cutaneous fistula (10.3%). A statistically significant relation was found between those aged older than 5 years and the rate of fistula development (three out of ten) (p-value = 0.023). Also, tourniquet time during the operation had a statistically significant relation with the incidence of fistula formation (mean time < 17.66 vs. > 20.5 minutes) in the fistula free vs. fistula group respectively (p =0.046). Conclusion: Reconstructive surgeries for hypospadias at earlier ages and with as short as possible tourniquet time reduce the incidence of fistula formation post-operatively.