The Development of Microsurgical Techniques in Experimental and Clinical Repair of Urethrocutaneous Fistulas

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Abstract
Urethral fistulas (60) in patients (50) seen between 1974 and 1979 were reviewed. After the results were assessed technical aspects of the repair were incriminated to account for the 40% failure rate for 1st-time closure of urethral fistulas. To study this problem an animal model [rabbit] was created in the laboratory. A comparison was made between classically repaired fistulas and those repaired with microsurgical equipment and techniques. In the group repaired by a classical macrosurgical technique only 20% of the repairs were successful, while 90% of the repairs under the microscope succeeded. Techniques and material, as well as histology involved, are presented in detail. Some of the causes of fistula repair breakdown include tissue trauma para fistula fistulas due to needle trauma and nonrecognition of multiple small additional fistulas. Details of 25 fistulas in 19 patients in whom closures were done with microsurgical techniques are presented. Success rate for primary closure was 88%.

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