This post briefly introduces one of the common post-surgery complications, fistula.
What Is a Fistula?
A fistula is a small hole that forms below the normal urinary opening after hypospadias surgery. It causes urine to leak from an abnormal site when the boy pees. They are one of the most common complications following hypospadias repair, and the complicate rate can vary from 4% to 25% or above depending on the surgical techniques, the hypospadias severity, the operation history, the healing status and so on.
Here is an example picture of a fistula:
When Does It Occur?
- Most fistulas appear within weeks to months after surgery.
- Rarely, they may show up years later.
- Early signs include urine leakage from an unintended spot after catheter removal.
Common Locations
Fistulas may develop anywhere below the normal opening, and many just appear just under the glans (penis head).
Are There Other Accompanying Complications?
While many boys with fistulas have no other complications, some may also develop:
- Persistent curvature (chordee)
- Urethral blockage beyond the fistula hole
- Ballooning of the new urethra during urination
These should be evaluated by your surgeon.
Treatment
Simple Fistulas
- If tissue around the glans is well-healed:
- Closure can often be done without a full redo surgery
- No catheter may be needed
- >90% success rate
Complex Fistulas
- If there are additional issues (e.g. curvature, scarring, poor healing):
- A redo hypospadias repair is required
- May involve catheter use and/or skin grafting
Follow-Up
Always schedule follow-up visits after surgery. If a fistula or any abnormal urination is noticed, contact your urologist promptly.
