Coronal fistula repair under the glans without reoperative hypospadias glansplasty or urinary diversion

This study is the first on fistula repair using a standardized procedure in consecutivepatients with prospectively recorded data. We found coronal fistulas ≤3 mm under well-fused glans wings can be repaired with low risk for recurrence by elevating the glans rather than re-opening the wings for reoperative glansplasty. Postoperative urinary diversion did not impact the recurrence rate and so is no longer used.94Figure. Coronal fistulas, (a) with well-fused glans wings allowing closure by dissection under the glans rather than reopening the wings, the subject of this manuscript, and (b) with glans dehiscence and a thin band of tissue stretching between the wings separating the fistula (indicated by arrow) from the meatus. These patients underwent reoperative hypospadias urethroplasty and glansplasty and were excluded from this report.