Fistula-tract Laser Closure (FiLaC™) for complex urethroperineal fistula

Background: Fistula formation in hidradenitis suppurativa follows an uncontrolled infection with subcutaneous tracts leading to 'watering-can' or 'pus-pot' perineum. Closure of this type of fistula implies major surgery and is bound to fail in refractory inflammatory environment. Minimally invasive techniques have become the first line of choice in every type of surgery. Methods: Fistula-tract Laser Closure (FiLaC (TM), Biolitec, Germany) is a novel technique already reported to have been used in the treatment of fistula-in-ano and pilonidal sinus. It consists of blind cauterization and obliteration of the fistula tract from the inside by means of a radial-emitting laser probe. We present two patients who underwent surgery for urethroperineal fistula using this technique. Results: In both cases, the fistula tracts were completely closed after 3 months of follow-up. The wounds had healed smoothly and complete resolution of symptoms was noted. Conclusions: The use of FiLaC (TM) for the treatment of urethroperineal fistula is feasible and safe. The minimally invasive nature of the technique and limited postoperative pain permit daycare surgery.