Giant 'Double Barreled' Urethrocutaneous Fistula Complicating Neonatal Circumcision - A Case Report

Introduction: Circumcision is the commonest operation done in males worldwide. Though it is a simple procedure, it can be fraught with an array of complications ranging from the mild to the serious and rarely fatal. Urethrocutaneous fistula is one of the serious complications of circumcision but fortunately it is rare.

In this case report, we share our experience on the successful management of a large sized ‘double barreled’ urethrocutaneous fistula that occurred following neonatal circumcision.

Case Report: A 13 year old boy presented with large ventral sub coronal ‘double barreled’ urethrocutaneous fistula that resulted from neonatal circumcision by a nurse. The informant was the mother. He also had bilateral intermittent testicular pain.

The fistula measured 3.0cm by 2.5cm after removing the intervening skin bridge. The external urethral meatus was normally sited. Both testes were in horizontal lie. A diagnosis of post circumcision urethrocutaneous fistula and bilateral intermittent testicular torsion was made.

The patient had bilateral orchidopexy and simple repair of urethrocutaneous fistula with satisfactory outcome.

Conclusions: Urethrocutaneous fistula is an infrequent complication of neonatal circumcision. This complication can be reduced if circumcision is carried out by trained surgeons rather than nurses.

Keywords: Penis; Circumcision; Complication; Urethrocutaneous fistula.