The Application of Multilayer Direct Closure With a Longitudinal Relaxing Incision in Urethrocutaneous Fistula Repair

Area of Science:

• Urology
• Surgical Techniques

Background:

• Direct suture closure of urethrocutaneous fistulas can lead to high recurrence rates due to tension.
• Minimizing tension at the surgical site is crucial for successful fistula repair.

Purpose of the Study:

• To describe a multilayer direct closure technique with a longitudinal relaxing incision for urethrocutaneous fistula repair.
• To evaluate the efficacy of this technique in reducing suture tension and improving healing outcomes.

Main Methods:

• A longitudinal relaxing incision was created adjacent to the primary wound after urethral fistula closure.
• The penile skin was then closed, utilizing the relaxing incision to relieve tension on the fistula repair site.
• The technique was applied to 46 urethrocutaneous fistulas in 34 patients between March 2015 and January 2018.

Main Results:

• All urethral fistula repairs were successful, with no signs of infection or poor wound healing.
• Relaxing incisions healed within 7–21 days, resulting in soft scars with minimal color difference from surrounding skin.
• The technique effectively reduced tension on the primary suture line, promoting favorable healing.

Conclusions:

• A multilayer direct closure incorporating a longitudinal relaxing penile skin incision is an effective method for urethrocutaneous fistula repair.
• This technique minimizes suture tension, leading to successful healing and reduced recurrence rates.
• The described method offers a favorable environment for urethral fistula repair, enhancing patient outcomes.