Clinical Profile and Surgical Outcome of Paediatric Patients Diagnosed with Urethrocutaneous Fistula following Circumcision: A Retrospective Descriptive Study

Introduction: Circumcision is one of the oldest and most common surgical procedures performed in the world. While circumcision is generally considered a simple and short procedure, it can lead to undesirable complications, such as Urethrocutaneous Fistula (UCF). The repair of UCF is quite challenging for surgeons, with high chances of recurrence, often requiring multiple surgical procedures. Aim: To study the clinical profile of patients with UCF and the outcomes of various surgical repair techniques. Materials and Methods: This retrospective descriptive study was conducted in the Department of General Surgery at Government Medical College, Jammu, Jammu and Kashmir, India, from January 2016 to January 2023. A total of 30 male patients with UCF fistula following circumcision were included. The category of the circumcisionist, site and size of the fistulae, type of repair, and associated complications were recorded. Results were expressed in terms of frequency and percentage. Results: The age of the patients varied from nine months to eight years. Circumcision was most commonly performed by traditional circumcisionists, accounting for 22 (73.3%) subjects. Approximately 18 (60%) of the patients had a coronal fistula. The size of the defect varied from 2 to 9 mm. All patients had a single UCF. Simple closure was performed in 20 patients, while eight patients underwent Tubularised Incised Plate (TIP) repair, and two patients had Mathieu flip-flap urethroplasty. The most common complication was refistulisation, observed in four patients. Conclusion: Public awareness regarding circumcision by trained surgeons and additional training for healthcare providers is essential to prevent the formation of UCF.