Risk factors for fistula recurrence after urethrocutaneous fistulectomy in children with hypospadias

Abdullaev, Zafar; Agzamkhodjaev, Saidanvar; Chung, Jae Min

doi:10.5152/tud.2020.20323

Cited by 8 publications

(6 citation statements)

References 28 publications

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“…At present, there are many studies on the incidence of the first UF, but there are few on the incidence of recurrent UF after the first fistula repair. The multiple UF incidence reported by Abdullaev et al, Yassin et al, and Aldaqadossi et al are 19%, 22.3%, and 4.4%, respectively ( 9 – 11 ). However, the sample size in their studies on multiple UF was small, including 63 cases in Abdullaev et al and 67 cases in Yassin et al, and only 45 cases in Aldaqadossi et al, all of which are retrospective studies, so the conclusions are not completely reliable.…”

Section: Discussionmentioning

confidence: 87%

“…There are many studies on the influencing factors of the initial UF but few on the multiple UF. Hypospadias degree, length of formed urethra, and the type of material used to cover the fistula are determined to be related to the recurrence of UF ( 9 , 11 ). Our study suggests the vesicostomy tube as a method of urinary drainage after urethroplasty and the existence of purulent urethral secretions after the first fistula repair will lead to multiple UF.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of influencing factors of multiple urethrocutaneous fistula after urethroplasty in children with hypospadias

2023

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ObjectiveThe objective of this study was to investigate the influencing factors of multiple urethrocutaneous fistula (UF) after urethroplasty in children with hypospadias.MethodsThe clinical data of 195 children with UF after urethroplasty treated surgically in the Third Affiliated Hospital of Zhengzhou University from August 2015 to August 2022 were retrospectively analyzed and divided into the single UF group (n = 134) and the multiple UF group (n = 61) according to whether multiple UF occurred after urethroplasty. The possible correlated factors were collected and compared between the two groups, including hypospadias degree, length of formed urethra, time of urethroplasty, pre-urethroplasty weight, age at urethroplasty, urethroplasty style, season of urethroplasty, the first fistula repair method, season of the first fistula repair, diameter of the largest fistula of the first fistula repair, time of the first fistula repair surgery, and other 13 factors.ResultsBy univariate analysis, statistically significant differences were found between the two groups in age at urethroplasty, length of the formed urethra, method of urinary drainage after urethroplasty, whether or not purulent urethral drainage after first fistula repair was present, the first fistula repair method, and diameter of the largest fistula of the first fistula repair (P < 0.05). After multifactorial analysis, the independent risk factors associated with multiple UF after urethroplasty were determined to be use of a vesicostomy tube as the urinary drainage method after urethroplasty (P < 0.05, OR = 6.574, 95% CI: 2.720–15.891) and the presence of purulent urethral drainage after first fistula repair (P < 0.05, OR = 2.723, 95% CI: 1.214–6.109).ConclusionsA catheter as the drainage method after urethroplasty is an independent protective factor for multiple urethrocutaneous fistula, and the existence of purulent urethral secretions after the first fistula repair is an independent risk factor.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Analysis of influencing factors of multiple urethrocutaneous fistula after urethroplasty in children with hypospadias

2023

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“…Numerous factors, such as UCF characteristics, meatal stenosis, local tissue conditions surrounding the stula, details of the initial urethroplasty, and the surgical skills of the surgeon, are believed to be associated with the development of UCF recurrence [4,5]. The incidence of UCF recurrence has been reported to be approximately 20% in previous studies [2][3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…The condition during primary HR, such as defect in urethra length and the approach of urethroplasty, might affect the success rate of UCF repair, as different complication rates arise from different types of urethroplasty [5]. In our previous study, we observed that preserving the urethral plate or transecting it resulted in different UCF rates: 6.2% (59/949) and 3.2% (14/437), respectively [12].…”

Section: Discussionmentioning

confidence: 99%

“…A recent meta-analysis of 2886 patients who underwent UCF repair found that 539 experienced recurrences, with success rates for different approaches ranging from 54.5-100% [3]. Various risk factors for recurrent UCF have been explored, apart from the characteristic of UCF itself, such as the type of hypospadias, the length of urethral defect, and urethral operation history [4][5][6]. Drawing from our clinical experience, the e cacy of UCF repair appears to hinge primarily on the UCF's intrinsic nature rather than extraneous elements.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of Treatment Failure in Urethrocutaneous Fistula Repair for Hypospadias: A Retrospective Analysis

Zhang,

Sun,

Zhang

et al. 2024

Preprint

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Purpose This study aimed to identify risk factors associated with the recurrence of urethrocutaneous fistula (UCF) following repair in patients with hypospadias, beyond the intrinsic characteristics of the fistula itself. Methods Clinical data of patients who underwent UCF repair were retrospectively reviewed. Potential risk factors included age and body mass index at UCF repair, history of low birth weight and prematurity, urethral defect length, operative approaches and urethral covering during hypospadias repair (HR), interval between urethroplasty and UCF presentation, interval between urethroplasty and UCF repair, meatal stenosis, size, number and location of UCFs. Univariate and multivariate analysis were used to identify the risk factors of UCF recurrence. Results A total of 136 patients underwent UCF repair from 2013 to 2022, and UCF recurred in 31 patients (22.8%) after a median follow-up of 36.2 months. Results of multivariate analysis showed that the UCF with a diameter exceed 4mm (OR6.968, 95% CI 1.522–31.898, P=0.012), multiple UCFs (OR 4.017, 95% CI 1.284–12.571, P=0.017), coronal UCF (OR 2.964, 95% CI 1.142–7.695, P=0.026) and urethral covering with non-Buck’s fascia (OR 2.631, 95% CI 1.015–6.819, P=0.047) were statistically significant, correlating with the risk of UCF recurrence. Conclusion UCF repair was more prone to failure if the size of UCF exceeds 4 mm, if it is located at the coronary sulcus, if multiple UCFs are present. Employing Buck’s fascia during HR would reduce the incidence of UCF recurrence.

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Management of urethral fistula after hypospadias repair with particular reference to purse-string sutures: a 24-year review

2022

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Risk factors for fistula recurrence after urethrocutaneous fistulectomy in children with hypospadias

Cited by 8 publications

References 28 publications

Analysis of influencing factors of multiple urethrocutaneous fistula after urethroplasty in children with hypospadias

Analysis of influencing factors of multiple urethrocutaneous fistula after urethroplasty in children with hypospadias

Predictors of Treatment Failure in Urethrocutaneous Fistula Repair for Hypospadias: A Retrospective Analysis

Management of urethral fistula after hypospadias repair with particular reference to purse-string sutures: a 24-year review

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