WVU Medicine Children’s Physician Develops New Technique to Lessen Surgical Complications

A WVU Medicine Children’s physician has developed a new surgical technique to lessen complications for pediatric urology patients.

Osama Al-Omar, MD, MBA, professor and chief of Pediatric Urology, spent the last three years working to eliminate urethrocutaneous fistula (UCF), one of the most common complications of hypospadias surgery. His work was recently published in the Journal of Pediatric Urology.

Hypospadias is a birth defect that happens during the fetal development of the male reproductive organs. Patients with this condition have urological surgery to correct it between six months and one year after they are born. The UCF complication happens in about five to 10 percent of these cases.

“Every time I see a patient with UCF complications, I feel deeply concerned knowing they will require additional surgery to repair it,” Dr. Al-Omar said. “This motivated me to improve the current surgical technique, leading to the development of a new approach aimed at minimizing or eliminating the risk of UCF.”

Dr. Al-Omar began working on this novel technique using De-Epethelialized Rotational Foreskin Flap (DERFF) coverage in 2022. Typical urethra repair utilizes one or two tissue flaps to minimize UCF. This new technique uses three layers of well-vascularized tissues flaps over the urethral repair.

“Having fewer complications means fewer surgeries,” Dr. Al-Omar, said. “That translates into fewer doctors’ appointments, less family separation, and reduced stress for the child and their family.”

After more than 60 consecutive cases and a median follow-up of seven months, no patients have had UCF complications with this new technique. Dr. Al-Omar said most issues usually happen in the first nine months after surgery.

“Any new surgical technique must demonstrate consistency and reproducibility,” he said. “We are now exploring whether other surgeons are interested in adopting this technique and achieving comparable outcomes.”

Now, Dr. Al-Omar is working on collecting long-term data on the technique by seeing patients more than one year after their surgery. He plans to continue to publish his findings.

“At the WVU Medicine Children’s Pediatric Urology Program, our mission is to provide the best available medical care for our patients,” Dr. Al-Omar said. “We continue to challenge ourselves to improve our surgical outcomes and pay special attention to patient safety by decreasing the risk of surgical complications to the best of our ability.”