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Case Report

Spontaneous Urethrocutaneous Fistula in Child with Spastic Cerebral Palsy: A Case Report


1 Department of Pediatric Surgery, Gebze Yuzyil Hospital, Gebze, Kocaeli, Türkiye
2 Department of Urology, Gebze Yuzyil Hospital, Gebze, Kocaeli, Türkiye


DOI : 10.33719/nju1363695
New J Urol. 2024;19(1):38-41.

Abstract

Urethrocutaneous fistulas are complications that usually seen after hypospadias repair. Spontaneous urethrocutaneous fistulas are extremely rare disorders unless related to the surgery of hypospadias. These fistulas are not associated with hypospadias repair, infection and trauma. While there are few cases reported in adults, there are no cases reported in children. Urethrocutaneous fistulas may rarely be encountered post-trauma, infection or due to weakness of spongious tissue of penis as well as. Children with spastic cerebral palsy often face various problems due to prolonged hospitalizations. Pressure ulcers are among the most common of these issues. Urinary catheterization is frequently performed in these patients for urine monitoring. A 6-year-old male patient with cerebral palsy developed a urethrocutaneous fistula while being monitored in the pediatric intensive care unit. Pre-existing unnoticed partial prepuce and weakness in the corpus spongiosum were present in the patient. We suspect that the development of the urethrocutaneous fistula is attributed to frequent urethral catheterization and the development of decubitus ulcer in the penile region. Since a similar case is not found in the pediatric literature, our aim is to present this case for reference.

Keywords: Cerebral Palsy; Hypospadias; Urethral fistula; Decubitus ulcer.


Abstract

Urethrocutaneous fistulas are complications that usually seen after hypospadias repair. Spontaneous urethrocutaneous fistulas are extremely rare disorders unless related to the surgery of hypospadias. These fistulas are not associated with hypospadias repair, infection and trauma. While there are few cases reported in adults, there are no cases reported in children. Urethrocutaneous fistulas may rarely be encountered post-trauma, infection or due to weakness of spongious tissue of penis as well as. Children with spastic cerebral palsy often face various problems due to prolonged hospitalizations. Pressure ulcers are among the most common of these issues. Urinary catheterization is frequently performed in these patients for urine monitoring. A 6-year-old male patient with cerebral palsy developed a urethrocutaneous fistula while being monitored in the pediatric intensive care unit. Pre-existing unnoticed partial prepuce and weakness in the corpus spongiosum were present in the patient. We suspect that the development of the urethrocutaneous fistula is attributed to frequent urethral catheterization and the development of decubitus ulcer in the penile region. Since a similar case is not found in the pediatric literature, our aim is to present this case for reference.

Keywords: Cerebral Palsy; Hypospadias; Urethral fistula; Decubitus ulcer.