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Defining the Indications of PATIO Technique for Urethrocutaneous Fistula Repair
INTRODUCTION: Despite the advancements in technique and technology, urethrocutaneous fistula (UCF) formation continues to be the most common complication after hypospadias repair. OBJECTIVE: The objective of the current synthesis is to define the indications of PATIO technique for UCF repair. MATERI...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569280/ https://www.ncbi.nlm.nih.gov/pubmed/37842208 http://dx.doi.org/10.4103/jiaps.jiaps_25_23 |
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author | Choudhury, Prativa Phugat, Shivani Jain, Vishesh Yadav, Devendra Kumar Dhua, Anjan Kumar Verma, Vivek Verma, Ajay Anand, Sachit Singh, Sanchita Goel, Prabudh |
author_facet | Choudhury, Prativa Phugat, Shivani Jain, Vishesh Yadav, Devendra Kumar Dhua, Anjan Kumar Verma, Vivek Verma, Ajay Anand, Sachit Singh, Sanchita Goel, Prabudh |
author_sort | Choudhury, Prativa |
collection | PubMed |
description | INTRODUCTION: Despite the advancements in technique and technology, urethrocutaneous fistula (UCF) formation continues to be the most common complication after hypospadias repair. OBJECTIVE: The objective of the current synthesis is to define the indications of PATIO technique for UCF repair. MATERIALS AND METHODS: The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, Ovid, Embase, Web of Science, and Google Scholar were interrogated for studies presenting primary data upon UCF repair by the PATIO technique. Data analysis was performed on MedCalc and R software. RESULTS: Eighteen studies were identified relevant to the current context: inversion of UCF tract has been described in 13 and ligation in 5. There were 2 duplications (abstract and manuscript). The overall success for PATIO is 88.2% (314/356). The success rate was variable between classic PATIO (inversion at 87.2%), ligation-inversion at 86.9%, and ligation alone at 88.9%. The success rate was not improvised upon by supplementing inversion of UCF tract with ligation (p = 0.957) or addition of a waterproofing layer (p = 0.622). PATIO has been used for single or multiple UCFs post hypospadias repair, genital piercing, and genitoplasty in cis- or transgender population for UCF up to 5 mm in size. The success rates were best for UCF <2 mm and worst for those approaching 5 mm. The results were, however, unaffected by the location of UCF along the penile shaft. Besides, the use of urethral catheter is optional and may be eliminated with shorter hospitalization. CONCLUSIONS: PATIO repair may be considered for repair of UCFs (a) with diverse etiologies, (b) located anywhere along the penile shaft included coronal UCF, (c) preferably <4 mm in size, (d) single or multiple in number; multiple PATIOs may be done in the same setting, (e) in patients unwilling for prolonged hospitalization, (f) in patients unwilling for a urethral catheter, and (g) in hypospadias cripples wherein mobilization of distant tissues such as tunica vaginalis flap or a buccal mucosal graft may be required for supplementing the UCF repair. |
format | Online Article Text |
id | pubmed-10569280 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-105692802023-10-13 Defining the Indications of PATIO Technique for Urethrocutaneous Fistula Repair Choudhury, Prativa Phugat, Shivani Jain, Vishesh Yadav, Devendra Kumar Dhua, Anjan Kumar Verma, Vivek Verma, Ajay Anand, Sachit Singh, Sanchita Goel, Prabudh J Indian Assoc Pediatr Surg Original Article INTRODUCTION: Despite the advancements in technique and technology, urethrocutaneous fistula (UCF) formation continues to be the most common complication after hypospadias repair. OBJECTIVE: The objective of the current synthesis is to define the indications of PATIO technique for UCF repair. MATERIALS AND METHODS: The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, Ovid, Embase, Web of Science, and Google Scholar were interrogated for studies presenting primary data upon UCF repair by the PATIO technique. Data analysis was performed on MedCalc and R software. RESULTS: Eighteen studies were identified relevant to the current context: inversion of UCF tract has been described in 13 and ligation in 5. There were 2 duplications (abstract and manuscript). The overall success for PATIO is 88.2% (314/356). The success rate was variable between classic PATIO (inversion at 87.2%), ligation-inversion at 86.9%, and ligation alone at 88.9%. The success rate was not improvised upon by supplementing inversion of UCF tract with ligation (p = 0.957) or addition of a waterproofing layer (p = 0.622). PATIO has been used for single or multiple UCFs post hypospadias repair, genital piercing, and genitoplasty in cis- or transgender population for UCF up to 5 mm in size. The success rates were best for UCF <2 mm and worst for those approaching 5 mm. The results were, however, unaffected by the location of UCF along the penile shaft. Besides, the use of urethral catheter is optional and may be eliminated with shorter hospitalization. CONCLUSIONS: PATIO repair may be considered for repair of UCFs (a) with diverse etiologies, (b) located anywhere along the penile shaft included coronal UCF, (c) preferably <4 mm in size, (d) single or multiple in number; multiple PATIOs may be done in the same setting, (e) in patients unwilling for prolonged hospitalization, (f) in patients unwilling for a urethral catheter, and (g) in hypospadias cripples wherein mobilization of distant tissues such as tunica vaginalis flap or a buccal mucosal graft may be required for supplementing the UCF repair. Wolters Kluwer - Medknow 2023 2023-09-05 /pmc/articles/PMC10569280/ /pubmed/37842208 http://dx.doi.org/10.4103/jiaps.jiaps_25_23 Text en Copyright: © 2023 Journal of Indian Association of Pediatric Surgeons https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Choudhury, Prativa Phugat, Shivani Jain, Vishesh Yadav, Devendra Kumar Dhua, Anjan Kumar Verma, Vivek Verma, Ajay Anand, Sachit Singh, Sanchita Goel, Prabudh Defining the Indications of PATIO Technique for Urethrocutaneous Fistula Repair |
title | Defining the Indications of PATIO Technique for Urethrocutaneous Fistula Repair |
title_full | Defining the Indications of PATIO Technique for Urethrocutaneous Fistula Repair |
title_fullStr | Defining the Indications of PATIO Technique for Urethrocutaneous Fistula Repair |
title_full_unstemmed | Defining the Indications of PATIO Technique for Urethrocutaneous Fistula Repair |
title_short | Defining the Indications of PATIO Technique for Urethrocutaneous Fistula Repair |
title_sort | defining the indications of patio technique for urethrocutaneous fistula repair |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569280/ https://www.ncbi.nlm.nih.gov/pubmed/37842208 http://dx.doi.org/10.4103/jiaps.jiaps_25_23 |
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