Cecil-Culp procedure for salvage repair of urethrocutaneous fistula following a circumcision complication: A case report.

Background: Circumcision, a globally prevalent surgical procedure, carries the risk of complications, including the rare occurrence of urethrocutaneous fistula (UCF). Treatment options for UCF range from conservative management to complex surgical repairs, such as the Cecil-Culp procedure. This study aims to evaluate the efficacy of the Cecil-Culp procedure in repairing UCF following circumcision.

Methods: A 2-year-old boy with a history of circumcision developed UCF and loss of penile skin as a complication, leading to surgical repair using conventional methods and subsequently an inguinal flap and tunica vaginalis flap procedure due to insufficient skin. Despite these interventions, the patient showed poor healing and the UCF persisted. Consequently, 6 months later, re-surgery was planned utilizing the Cecil-Culp procedure. Postoperatively, the patient demonstrated favorable outcomes in surgical wound healing, with no recurrence of the UCF.

Conclusions: UCF is a rare but significant complication of circumcision. Treatment strategies depend on the size, location, and severity of the fistula, ranging from primary closure to complex flap-based repairs. In this case, after failed conventional methods, the Cecil-Culp technique was employed. This two-stage procedure, which involves temporarily burying the urethra in the scrotum, provided adequate tissue coverage and resulted in successful healing with no recurrence. Long-term follow-up is recommended to assess potential complications. Conclusions: The Cecil-Culp procedure proved to be an effective surgical option for UCF repair following circumcision, particularly in cases with inadequate penile skin. Long-term monitoring remains essential to evaluate possible complications.