Repairing urethrocutaneous fistula in adults: is a catheter necessary?

To demonstrate that urethrocutaneous fistulas can be repaired under local anesthesia in adult patients without catheters.

From 1998 to 2006, 96 patients with urethrocutaneous fistulas underwent repair under local anesthesia. The patients were divided into two groups in terms of whether they did or did not have a catheter placed. The catheterized group included 45 patients and the uncatheterized group included 51 patients. The uncatheterized patients were discharged on the operation day, and the catheterized patients were discharged 1 to 4 days postoperatively. Patients were reevaluated on the 7th postoperative day and after 3 months in terms of wound infection, urethral stricture, and fistula recurrence.

All patients tolerated the fistula repair well under local anesthesia. The success rate of fistula repair was 93.3% and 94.1% in the catheterized and uncatheterized groups, respectively. Wound infection was seen in 6 patients in the first group but was not noted in the uncatheterized group. Fistulas recurred in 3 patients in each group (6.6% and 5.8%) after 3 months postoperatively.

Catheterless fistula repair with local anesthesia in adults is an effective, safe, and inexpensive procedure.