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SURGICAL REPAIR OF URETHROCUTAEOUS FISTULA IN A MALE WITH PREVIOUS ISOLATED EPISPADIAS - A CASE REPORT
Muthanna Saad Abduljawad* and Hajir H Al-Ridhwany Ph.D CM
Introduction: Isolated male epispadias is a rare congenital penile malformation that describes a defect of the dorsal aspect of the penis, leaving the urethral plate open. It may associated with urinary incontinence. Aim: The current case report study is aiming for presenting a successful one stage-surgical repair of a large urethral fistula situated at the dorsum of the penile boy in a patient with a history of isolated epispedis corrected with multiple previous failed attempts. Subject and method: The studied case was a 23 years old male who presented to Urology Department in Medicano Hospital in Erbil, at the north of Iraq, in Jan. 2020 with an evidence of urethral fistula at the dorsum of the penis. The patient had a history of congenital isolated male epispadias with failure of previous surgical repair. Clinical examination revealed a large fistula at the dorsum of the penile body with indurated edges and everted urethral wall. The glandular urethral opening was patent. A Foley catheter was introduced from the glandular urethral orifice bypassing the fistula to the bladder. Closure of the edges of the urethral wall around the Foley catheter. A flap was taken from the dartos fascia to cover the site of the closed urethral incision. Conclusion and Recommendation: Complete excision of the scar tissue and utilization of more than one layer of flap over the closure site are advisable for repair of urethrocutaneous fistula.[Full Text Article]