Outpatient department repair of urethrocutaneous fistulae using n-butyl-cyanoacrylate (NBCA): a single-centreexperience.

OBJECTIVES To evaluate urethrocutaneous fistula repair after urethroplasty using n-butyl cyanoacrylate (NBCA) in an outpatient setting. To compare results of application of NBCA in 'early' and long-standing fistulae. PATIENTS AND METHODS From January 2003 to December 2006, 13 children (mean age 36 months) were treated in our Outpatient Department for urethrocutaneous fistula, which occurred after hypospadias repair. We analysed the data dividing the patients in two groups: group A comprised six children (mean age 22.6 months) that developed a fistula within 2-3 days of catheter removal after urethroplasty ('early' fistula) and group B comprised seven children (mean age 42.6 months) with long-standing fistulae. In all patients, a multilayer of NBCA was applied, attaching the edges of the fistula taking care to perform a scarification of the edges of the fistula in patients in group B before the application of the glue. RESULTS Four patients in group A and three patients in group B had definitive fistula repair (seven of 13), and six of the 13 had fistula recurrence. Fistulae of ≤2 mm were more easily repaired than fistulae of >2 mm (five of seven vs two of six). Fistulae that tended to recover were those that responded to the first applications. CONCLUSIONS: In this experience the use of NBCA as a minimally invasive treatment for fistula repair gave good results for repairing fistulae. These preliminary results encourage the use of NBCA as a first non-surgical attempt to repair urethrocutaneous fistulae especially if the fistula is a;circ2 mm. The failure of this procedure does not compromise a possible subsequent surgical repair. © 2011 BJU INTERNATIONAL.