PATIO technique for repair of distal urethrocutaneous fistula
Published Date: 01st October 2025
Publication Authors: Pina. IM, Omar. AM, Floyd Jr. MS
Introduction
The “Preserve it and turn it inside out (PATIO)” technique is a recognised method for treatment of distal Urethrocutaneous fistulae following hypospadias repair.
Methods
A cystoscopy is performed to delineate the stricture and assess the entire lower tract, following which a catheter is passed. Instillagel is instilled to demonstrate the ventral fistula. The fistula is then marked and a glans stay suture placed. The fistula is gently mobilised circumferentially and an access catheter passed ventrally trough the fistula and meatus, following which the defect is measured. A stay suture is placed at the proximal end of the fistula. A Forceps is introduced via the meatus and passed through the fistula with a prolene suture. This is then tied to the stay suture and the fistula is pulled through the meatus and catheter removed. The meatus is refashioned and fistula inverted and sutured to the meatal incision with vicryl rapide. The meatus is then recalibrated with soft tip dilators and meatoplasty performed. The ventral skin defect is then closed and wound dressed. No catheter is passed.
Results After 1 week the patient returns for wound review.
Conclusion
The patient is assessed at 3 months with repeat symptom scores showing complete symptom resolution. The PATIO repair can be carried out on a day-case basis with minimal blood loss and no requirement for a catheter.
Pina, IM; Omar, AM; Floyd Jr. MS. (2025). PATIO technique for repair of distal urethrocutaneous fistula. European Urology Open Science. 80(Supplement 1), p.S31