Persistent urethrocutaneous fistu­la following hypospadias repair and circumcision presents a surgical chal­lenge with a high rate of recurrence. The present series evaluates the val­ue of reinforcement of the repair by interpositioning of a vascularized flap. 24 boys suffering from urethral fistula (4 following circumcision and 20 fol­lowing hypospadias surgery) were equally divided into two groups. The 1st group were managed by modified two layers closure with skin flap cov­erage and the 2nd group were man­aged by 3 layers closure with inter-positioned flap. Cases were followed up for 6-20 months. The success rate in 1st group was 66.6% versus 91% in the 2nd group (raised to 75% ver­sus 100% after spontaneous closure of one fistula in each group). The present series shows that ad-
dition of interposition flap to the repair of urethrocutaneous fistula appears to reduce the incidence of fistula recur­rence significantly.