Identification of risk factors associated with numerous reoperations following primary hypospadias repair

Ru, Wei; Tang, Daxing; Wu, Dehua; Chang, Tao; Chen, Guangjie; Wei, Jia; Tian, Hongjuan; Shu, Qiang

doi:10.1016/j.jpurol.2020.11.010

Cited by 15 publications

(13 citation statements)

References 16 publications

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“…18 However, Ru et al have reported that age was not associated with the incidence of complications after primary repair in children. 19 Our results revealed that age was not a risk factor for PH in patients with severe chordee repair. In this study, erection factors may have played a limited role because most children were young.…”

Section: Discussionmentioning

confidence: 49%

Risk factors for postoperative complications in children with proximal hypospadias with severe chordee who underwent urethral plate transection

et al. 2022

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Objectives To identify the risk factors associated with developing complications after transection of the urethral plate for proximal hypospadias with severe chordee. Methods We used a prospective database to identify patients with proximal hypospadias and severe chordee who underwent transection of the urethral plate and primary hypospadias repair in 2011 and 2021. All patients underwent urethroplasty with a follow‐up period of >12 months. The association between variables (age, surgical technique, length of urethral defect, and surgeon volume) and postoperative complications (fistulas, urethral strictures, diverticula and glans dehiscence) was analyzed. Results Altogether, 493 patients were included, of whom 133 (26.9%) had postoperative complications. Univariate and multivariate analyses revealed that the preoperative proximal meatal position, one‐stage repair, longer urethral defect length, and low surgeon volume were significant risk factors for postoperative complications with proximal hypospadias with severe chordee who underwent transection of the urethral plate. A urethral defect length of ≥4.55 cm was considered the best cutoff value for predicting postoperative complications. Conclusions Preoperative proximal meatal location, one‐stage repair, longer urethral defect length, and low surgeon volume were associated with postoperative complications in patients with proximal hypospadias with severe chordee who underwent transection of the urethral plate. A urethral defect length of ≥4.55 cm was significantly associated with the development of complications.

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Section: Discussionmentioning

confidence: 49%

Risk factors for postoperative complications in children with proximal hypospadias with severe chordee who underwent urethral plate transection

et al. 2022

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“…This factor becomes a burden for a surgeon to perform corrective surgery well. This difficulty may also lead to several postoperative complications, causing morbidity and a lower quality of life (Lucas et al 2020, Ru et al 2021. Based on these considerations, several studies have been investigating several methods to increase penis size before surgery.…”

Section: Discussionmentioning

confidence: 99%

Pre-Operative Hormonal Administration in Hypospadias Patients Undergoing Urethroplasty

Ramadhani

Renaldo

2022

FMI

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Highlight:The gold standard therapy of hypospadias is reconstructive surgery.Glans diameter and penile length are factors influencing urethroplasty outcomes.Many studies are being conducted to investigate various methods of increasing the size and diameter of the penis prior to the operation in order to reduce complications. Preoperative testosterone hormonal therapy is able to reduce overall complication and urethrocutaneous fistula in hypospadias patient undergoing urethroplasty.Abstract:The gold standard of treatment for hypospadias patients is reconstructive surgery. The result and post-operative complication of urethroplasty were affected by glans diameter and penile length. Pre-operative testosterone administration, both parenterally or topically, has become one of the main interests to increase the size and diameter of penis to minimize post-operative complications. However, there has not been enough evidence to justify this recommendation. Therefore, we aimed to perform a systematic review and meta-analysis to evaluate the role of pre-operative testosterone to prevent postoperative complications after urethroplasty in hypospadias patients. Online databases of Medline, Scopus and Embase were searched until October 2021 to identify RCT studies evaluating the effect of testosterone hormone therapy in reducing post-operative complication on hypospadias patient undergoing urethroplasty. Data analysis was performed using RevMan 5.4. A total of 4 RCTs were included in the analysis of this study with the total of 211 patients. Pre-operative testosterone hormonal therapy significantly reduced the overall complications group (OR=0.17; 95% CI=0.04, 0.77; p=0.02), post-operative urethrocutaneous fistula (OR=0.4, 95% CI=0.19, 0.83, p=0.01). Finally, there was no significant effect on the incidence of dehiscence and meatal stenosis with OR of 0.59, 95% CI=0.23, 1.54, p = 0.28, and 0.277; 95% CI=0.04, 1.65; p=0.16, respectively. Pre-operative testosterone hormonal therapy could reduce overall complication and urethrocutaneous fistula in hypospadias patients undergoing urethroplasty.

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“…Although the included studies involved few numbers of surgical procedures and tried to answer a straight question related to surgical outcomes, they included a wide range of patients ages (clinical diversity) and different ways to assess the urethral plates (methodological heterogeneity). There is a wide variation of clinical phenotypes of hypospadias including different meatal positions [27], glans size [25], presence and degree of chordee [28] etc. That could potentially jeopardize the validity and reproducibility of such studies' conclusions.…”

Section: Limitationsmentioning

confidence: 99%

Urethral plate quality assessment and its impact on hypospadias repair outcomes: A systematic review and quality assessment

Abbas

Braga

Spinoit

et al. 2021

Journal of Pediatric Urology

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Identification of risk factors associated with numerous reoperations following primary hypospadias repair

Cited by 15 publications

References 16 publications

Risk factors for postoperative complications in children with proximal hypospadias with severe chordee who underwent urethral plate transection

Risk factors for postoperative complications in children with proximal hypospadias with severe chordee who underwent urethral plate transection

Pre-Operative Hormonal Administration in Hypospadias Patients Undergoing Urethroplasty

Urethral plate quality assessment and its impact on hypospadias repair outcomes: A systematic review and quality assessment

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