Outcome of Small-Diameter Urethrocutaneous Fistula Repair: By Ligation with Cauterization versus only Ligation Technique

Authors

• Md Rabiul AwalAssistant Professor of Pediatric Surgery City Medical College Hospital, Gazipur, Dhaka, Bangladesh
• Md Tanzir AnwarHome Economist, Institute Public Health Nutrition, Dhaka, Bangladesh
• Md Abdul AzizProfessor of Pediatric Surgery, Dhaka Shishu Hospital & BICH, Dhaka, Bangladesh
• Farzana AfrinHonorary Medical Officer, National Institute of Mental Health & Hospital, Dhaka, Bangladesh
• Gufrana AfrinMedical Officer, National Institute of Laboratory Medicine & Referral Centre Dhaka, Bangladesh
• Mohammad Shoyeb

Keywords

Abstract

Urethrocutaneous fistula (UCF) remains the most prevalent and taxing complication following hypospadias surgery, necessitating secondary interventions that are often fraught with high recurrence rates. This article presents a comprehensive study comparing two surgical modalities for the management of small-diameter UCF (≤ 4 mm) in pediatric patients: ligation with diathermy cauterization of the external epithelium versus only ligation. Through a prospective randomized controlled trial involving 46 patients at the Dhaka Shishu (Children) Hospital, this research evaluates operative time, hospital stay, recurrence rates, and postoperative complications. While both techniques demonstrate high efficacy, the integration of diathermy cauterization offers a theoretical advantage in obliterating the epithelial lining of the fistula tract, potentially reducing the risk of recurrence. Comparing success rate and complications between groups there was no statistically significant differences. This article provides a deep dive into the historical, embryological, and clinical frameworks surrounding hypospadias and its complications, offering a professional roadmap for pediatric urologists and surgeons.

Journal of Paediatric Surgeons of Bangladesh (2026) Vol. 17 (2): 25–28