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Prof. Dr. Ali Avanoğlu
Hypospadias Surgery • Hypospadias in Adults

Urethrocutaneous Fistula in Adults

Urine is coming not only from the normal opening but from a second point as well. In adults, the most common cause of this picture is part of a childhood repair opening back up over the years.

Who this is forThose with urine coming from a second opening
Reading≈1 min
ByProf. Dr. Ali AvanoğluUpdated
This page is part of hypospadias surgery.Read the full treatment overview on the hub page
second opening after repair
01 · The one question that determines success02 · The second determining factor03 · Repair04 · A factor that affects healing
In brief4 madde
  • The one question that determines success: Is there a stricture further along from the fistula?
  • The second determining factor: Laying a living interposition layer over the closure.
  • Repair: If there is a stricture, it is cleared first.
  • A factor that affects healing: Smoking directly makes it harder for a fistula repair to hold; quitting before surgery is required.
01

The one question that determines success

Is there a stricture further along from the fistula? If there is, urine keeps taking the fistula's path instead of the route that offers resistance, and the closure fails. This is why most repeat fistula repairs fail.

  • Ask your doctor this question directly, and find out how it is being checked.
02

The second determining factor

Laying a living interposition layer over the closure. Simply stitching the opening closed is often not enough, particularly in adults.

03

Repair

  • If there is a stricture, it is cleared first.
  • Small fistula: closure plus an interposition layer.
  • Large or multiple fistulas: reconstruction of that segment of the channel.
  • If the surrounding tissue is unhealthy: graft-supported or staged repair.
04

A factor that affects healing

Smoking directly makes it harder for a fistula repair to hold; quitting before surgery is required.

Related videos
Full guide (19) →
Frequently asked questions
It is a small leak — is surgery really necessary?
Even when a fistula is small, the urine leak directly affects daily life and social comfort; repair is a legitimate request. The decision is made based on how much it is limiting you.
←Previous • Hypospadias in AdultsEjaculation ProblemsNext • Hypospadias in AdultsRecovery Process in Adults→
Related pagesFull index →
After SurgeryInterposition Layer in Fistula RepairWhat makes a fistula repair last is not the stitching itself. A layer of living tissue placed between the new channel and the skin keeps the two suture lines from overlapping, and it markedly reduces recurrence.Hypospadias in AdultsUrethral Stricture After Hypospadias in AdultsThe channel has narrowed following a repair done years earlier. This is the most common late complication of hypospadias surgery, and it usually appears during adolescence or adulthood.After SurgeryFistula After Hypospadias SurgeryAn opening has formed that leaks urine between the repaired channel and the skin. This is the most common complication in hypospadias surgery, and in most cases it can be closed permanently with a small, planned procedure.Recurrent CasesAdult Redo Hypospadias SurgeryThis is a picture where someone has had more than one procedure and problems have persisted. This group is called "salvage surgery"; the plan is built not around standard techniques but around an inventory of the tissue that remains.
Hypospadias Surgery topic clustersMain treatment page →
Basics 8Surgery in Children 8Surgical Techniques 5After Surgery 9Recurrent Cases 4Hypospadias in Adults 8Follow-up and Assessment 5
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