Management of Urethrocutaneous Fistula Following Circumcision in Mbour Hospital, Senegal

Purpose: We report the epidemiological, clinical and therapeutic aspects of Urethrocutaneous fistula which is an unusual but preventable complication following circumcision.

Materials and Methods: We carried out a retrospective and descriptive study, of all children who presented with urethrocutaneous fistula following circumcision over a period of 7 years,from March 2012 to February 2018.

Results: Eighteen patients (n=18) with Urethrocutaneous fistulas (UCF) following circumcision were treated in Mbour hospital (Senegal). The mean age was 6.61 years (Range: 2; 14 years). The mean consultation time in a specialized setting was 20 months (Range: 3 months; 2 years). The circumcision was performed by a non-physician health professional in 14 cases and by a traditional practitioner in 4 cases. Sixteen patients underwent an urethro-skin closure by the suture in two distinct lines. We made a broad-base skin flap for one patient and used Davis method for one case. All patients were admitted for 5 days and then followed up at 1 week, 1 month and 3 months.The therapeutic results were satisfactory in 88.88% (n = 16) of the cases after a follow-up of 1 year. Two cases of fistula recurrence was recorded and they were treated successfully.

Conclusions: Urethrocutaneous fistula following circumcision is frequently seen in our surgical practice. Its prevention requiresthe respect and control of the different stages of circumcision, but also education and training of healthcare professional performing the circumcision.

Keywords: urethrocutaneous fistula, Circumcision, complication, Senegal.