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Spontaneous Urethrocutaneous Fistula in Child with Spastic Cerebral Palsy: A Case Report

Year 2024, Volume: 19 Issue: 1, 38 - 41, 27.02.2024

Abstract

Urethrocutaneous fistulas are complications that usually seen after hypospadias repair. Spontaneous urethrocutaneous fistulas are extremely rare disorders unless related to the surgery of hypospadias. These fistulas are not associated with hypospadias repair, infection and trauma. While there are few cases reported in adults, there are no cases reported in children. Urethrocutaneous fistulas may rarely be encountered post-trauma, infection or due to weakness of spongious tissue of penis as well as.
Children with spastic cerebral palsy often face various problems due to prolonged hospitalizations. Pressure ulcers are among the most common of these issues. Urinary catheterization is frequently performed in these patients for urine monitoring. A 6-year-old male patient with cerebral palsy developed a urethrocutaneous fistula while being monitored in the pediatric intensive care unit. Pre-existing unnoticed partial prepuce and weakness in the corpus spongiosum were present in the patient. We suspect that the development of the urethrocutaneous fistula is attributed to frequent urethral catheterization and the development of decubitus ulcer in the penile region. Since a similar case is not found in the pediatric literature, our aim is to present this case for reference.

References

  • Ochsner MG, Joshi PN. Urethrocavernosus fistula. J Urol. 1982 Jun;127(6):1190. https://doi.org/10.1016/s0022-5347(17)54291-3
  • Santangelo K, Rushton HG, Belman AB. Outcome analysis of simple and complex urethrocutaneous fistula closure using a de-epithelialized or full thickness skin advancement flap for coverage. J Urol. 2003 Oct;170(4 Pt 2):1589-92; discussion 1592. https://doi.org/10.1097/01.ju.0000084624.17496.29
  • Palaniswamy R, Rao MS, Bapna BC, Chary KS. Urethro-cavernous fistula from blunt penile trauma. J Trauma. 1981 Mar;21(3):242-3. https://doi.org/10.1097/00005373-198103000-00009
  • De Stefani S, Savoca G, Ciampalini S, Stener S, GattucCio I, Belgrano E. Urethrocutaneous fistula as a severe complication of treatment for priapism. BJU Int. 2001 Oct;88(6):642-3. https://doi.org/10.1046/j.1464-4096.2001.02400.x
  • Amukele SA, Stock JA, Hanna MK. Management and outcome of complex hypospadias repairs. J Urol. 2005 Oct;174(4 Pt 2):1540-2; discussion 1542-3. https://doi.org/10.1097/01.ju.0000176420.83110.19
  • Hardwicke JT, Bechar JA, Hodson J, Osmani O, Park AJ. Fistula after single-stage primary hypospadias repair- A systematic review of the It is likely that this patient had. J Plast Reconstr Aesthet Surg. 2015;68(12):1647-55. https://doi.org/10.1016/j.bjps.2015.07.024
  • Gulati S, Sondhi V. Cerebral Palsy: An Overview. Indian J Pediatr. 2018;85(11):1006-1016. https://doi.org/10.1007/s12098-017-2475-1
  • Grandhi TM, Shelley O, Ray AK, McGregor JR. Dorsal urethral fistula: case report and review of literature. Urology. 2004;63(1):175-6. https://doi.org/10.1016/j.urology.2003.09.031
  • Yucel M, Kabay S, Sahin L, Koplay M, Yalcinkaya S, Cucioglu T, Hatipoglu NK. Posttraumatic ventral urethral fistula: a case report. Cases J. 2009Sep3;2:8644. https://doi.org/10.1186/1757-1626-0002-0000008644
  • Graham HK, Rosenbaum P, Paneth N, Dan B, Lin JP, Damiano DL, Becher JG, Gaebler-Spira D, Colver A, Reddihough DS, Crompton KE, Lieber RL. Cerebral palsy. Nat Rev Dis Primers. 2016Jan7;2:15082. https://doi.org/10.1038/nrdp.2015.82
  • Akman RY, Cam K, Akyuz O, Erol A. Isolated congenital urethrocutaneous fistula. Int J Urol. 2005 Apr;12(4):417-8. https://doi.org/10.1111/j.1442-2042.2005.01050.x
  • Kanuck DM, Zgonis T, Jolly GP. Necrotizing fasciitis in a patient with type 2 diabetes mellitus. J Am Podiatr Med Assoc. 2006 Jan-Feb;96(1):67-72. https://doi.org/10.7547/0960067

Spontaneous Urethrocutaneous Fistula in Child with Spastic Cerebral Palsy: A Case Report

Year 2024, Volume: 19 Issue: 1, 38 - 41, 27.02.2024

Abstract

Urethrocutaneous fistulas are complications that usually seen after hypospadias repair. Spontaneous urethrocutaneous fistulas are extremely rare disorders unless related to the surgery of hypospadias. These fistulas are not associated with hypospadias repair, infection and trauma. While there are few cases reported in adults, there are no cases reported in children. Urethrocutaneous fistulas may rarely be encountered post-trauma, infection or due to weakness of spongious tissue of penis as well as.
Children with spastic cerebral palsy often face various problems due to prolonged hospitalizations. Pressure ulcers are among the most common of these issues. Urinary catheterization is frequently performed in these patients for urine monitoring. A 6-year-old male patient with cerebral palsy developed a urethrocutaneous fistula while being monitored in the pediatric intensive care unit. Pre-existing unnoticed partial prepuce and weakness in the corpus spongiosum were present in the patient. We suspect that the development of the urethrocutaneous fistula is attributed to frequent urethral catheterization and the development of decubitus ulcer in the penile region. Since a similar case is not found in the pediatric literature, our aim is to present this case for reference.

References

  • Ochsner MG, Joshi PN. Urethrocavernosus fistula. J Urol. 1982 Jun;127(6):1190. https://doi.org/10.1016/s0022-5347(17)54291-3
  • Santangelo K, Rushton HG, Belman AB. Outcome analysis of simple and complex urethrocutaneous fistula closure using a de-epithelialized or full thickness skin advancement flap for coverage. J Urol. 2003 Oct;170(4 Pt 2):1589-92; discussion 1592. https://doi.org/10.1097/01.ju.0000084624.17496.29
  • Palaniswamy R, Rao MS, Bapna BC, Chary KS. Urethro-cavernous fistula from blunt penile trauma. J Trauma. 1981 Mar;21(3):242-3. https://doi.org/10.1097/00005373-198103000-00009
  • De Stefani S, Savoca G, Ciampalini S, Stener S, GattucCio I, Belgrano E. Urethrocutaneous fistula as a severe complication of treatment for priapism. BJU Int. 2001 Oct;88(6):642-3. https://doi.org/10.1046/j.1464-4096.2001.02400.x
  • Amukele SA, Stock JA, Hanna MK. Management and outcome of complex hypospadias repairs. J Urol. 2005 Oct;174(4 Pt 2):1540-2; discussion 1542-3. https://doi.org/10.1097/01.ju.0000176420.83110.19
  • Hardwicke JT, Bechar JA, Hodson J, Osmani O, Park AJ. Fistula after single-stage primary hypospadias repair- A systematic review of the It is likely that this patient had. J Plast Reconstr Aesthet Surg. 2015;68(12):1647-55. https://doi.org/10.1016/j.bjps.2015.07.024
  • Gulati S, Sondhi V. Cerebral Palsy: An Overview. Indian J Pediatr. 2018;85(11):1006-1016. https://doi.org/10.1007/s12098-017-2475-1
  • Grandhi TM, Shelley O, Ray AK, McGregor JR. Dorsal urethral fistula: case report and review of literature. Urology. 2004;63(1):175-6. https://doi.org/10.1016/j.urology.2003.09.031
  • Yucel M, Kabay S, Sahin L, Koplay M, Yalcinkaya S, Cucioglu T, Hatipoglu NK. Posttraumatic ventral urethral fistula: a case report. Cases J. 2009Sep3;2:8644. https://doi.org/10.1186/1757-1626-0002-0000008644
  • Graham HK, Rosenbaum P, Paneth N, Dan B, Lin JP, Damiano DL, Becher JG, Gaebler-Spira D, Colver A, Reddihough DS, Crompton KE, Lieber RL. Cerebral palsy. Nat Rev Dis Primers. 2016Jan7;2:15082. https://doi.org/10.1038/nrdp.2015.82
  • Akman RY, Cam K, Akyuz O, Erol A. Isolated congenital urethrocutaneous fistula. Int J Urol. 2005 Apr;12(4):417-8. https://doi.org/10.1111/j.1442-2042.2005.01050.x
  • Kanuck DM, Zgonis T, Jolly GP. Necrotizing fasciitis in a patient with type 2 diabetes mellitus. J Am Podiatr Med Assoc. 2006 Jan-Feb;96(1):67-72. https://doi.org/10.7547/0960067
There are 12 citations in total.

Details

Primary Language English
Subjects Urology
Journal Section Case Reports
Authors

Sinan Kılıç 0000-0003-3454-5538

Samed Verep 0000-0002-1086-6380

Publication Date February 27, 2024
Published in Issue Year 2024 Volume: 19 Issue: 1

Cite

Vancouver Kılıç S, Verep S. Spontaneous Urethrocutaneous Fistula in Child with Spastic Cerebral Palsy: A Case Report. New J Urol. 2024;19(1):38-41.