Risk factors for urethrocutaneous fistula following hypospadias repair surgery in Indonesia (original) (raw)

Urethro-cutaneous fistula after hypospadia repair: a single institution study

Annals of African Surgery

Urethro-cutaneous fistula (UCF) is one of the most frequently seen complications of hypospadias surgery requiring reoperation; it occurs with an incidence of between 4% and 28%. Risk factors associated with the development of UCF can be classified as preoperative, intraoperative or postoperative. The aim of this study was to determine the association of perioperative risk factors and the development of urethrocutaneous fistula after hypospadias repair. A retrospective review of patients who had undergone hypospadias repair at Kenyatta National Hospital between 2013 and 2017 was conducted. 114 patient records were retrieved. The incidence of UCF was 47%. Risk factors that were significantly associated with UCF are hypospadias type (p=0.028), lack of a protective intermediate layer (p=0.002), and presence of postoperative complications (p=0.001). Age at surgery, suture material, type of repair and use of catheter/stents were not significant factors. Multivariate analysis showed wound infection and meatal stenosis as the most significant factors associated with UCF development.

Delayed presentation of Urethrocutaneous fistulae after hypospadias repair

Journal of Pediatric Surgery, 2020

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Risk Factors for Urethrocutaneous Fistulas Formation After One Stage Hypospadias Repair

Indonesian Journal of Urology, 2011

Objective: To evaluate risk factors that contribute to urethrocutaneous fistulas formation after one stage hypospadias repair. Material & method: A case control study was performed on hypospadias patients that underwent one stage hypospadias repair. We analyzed the correlation of urethrocutaneous fistula formation with patient age, hypospadias classification, chordee severity, other urogenital anomalies, history of hormonal therapy, suture size, duration of operation, type of dressing, type of stent, duration of stenting, and three types of operation technique, which are TIP, Duckett, and Onlay Island Flap. Results: There were 116 patients with mean age 5,7 ± 3,9 years old (4 months – 19 years old). Urethrocutaneous fistula occured in 12 patients (10,3%). From the data analysis, we didn’t find any significant correlation between urethrocutaneous fistula formation and patient’s age (p = 0,426), hypospadias classification (p = 0,695), chordee severity (p = 0,564), other urogenital ano...

Urethrocutaneous Fistula After Hypospadias Repair in children: Analysis of Risk Factors

Al-Azhar International Medical Journal

Background: Urethrocutaneous fistulas following hypospadias correction are one of the most prevalent hypospadias surgical complications. Hypospadias is one of the most frequent congenital malformations, with an almost universal upward trend over time. Aim of the study: We aim to review the rate of urethrocutaneous fistula (UCF) formation after the repair of hypospadias in children and try to analyze the possible risk factors for its formation. Patients and Methods: A total of 316 cases who underwent hypospadias surgery between February 2015 and December 2020 were included in this retrospective research. 246 children were followed up on for more than 6 months in our report. The child's age at the time of the hypospadias operation, the location of the hypospadias, the presence of chordae, the type of operation, the type of sutures and techniques, the approaches and period of catheter use after hypospadias operation, splint size, the level of experience of the participating surgeon, post-operative complications, presentation time of the fistula, size of fistula, the fistulae number, and the position of fistula were all potential risk factors. Results: Following hypospadias surgery, 49 children out of 246 developed urethrocutaneous fistulae (19.8%, 49/246). The type of hypospadias (P-0.006) and the nature of hypospadias operation (P-0.766) were found associated with the formation of the fistula in the univariate analysis. The hypospadias site only was a significant risk factor in the formation of fistulae after the surgery of hypospadias in the multivariate analysis (p＜ 0.001). Conclusion: After hypospadias correction, the likelihood of urethrocutaneous fistula formation is related to the site of hypospadias (greater in the proximal hypospadias). The type of hypospadias procedure, the suture utilized, and the method used were not linked to the formation of fistulae.

Our 23-Year Experience in Urethrocutaneous Fistulas Developing After Hypospadias Surgery

Urology, 2007

OBJECTIVES To determine the role of the fistula characteristics on the outcomes of repair in urethrocutaneous fistulas that develop after hypospadias surgery. METHODS A total of 160 patients who had undergone urethrocutaneous fistula repair after hypospadias surgery were enrolled in this study. The prognostic significance of the site, size, and number of fistulas, number of the previous operations, and the techniques applied were analyzed by the appropriate statistical methods as the parameters of the study. RESULTS The fistulas were localized at the distal, mid, or proximal penile region in 69 (43.2%), 60 (37.5%), and 31 (19.2%) patients, respectively. No statistically significant relation was found between the fistula site and the success rate (P Ͼ0.05). The fistula size (2 mm or less versus greater than 2 mm) and the number of fistula repairs (single versus two or more) also did not affect the outcome (P Ͼ0.05, Pearson chi-square and Fisher's exact tests). CONCLUSIONS The site, size, and number of the fistula repair seemed to have no impact on the success rate. Well-known aspects of the modern hypospadias surgery (eg, delicate tissue handling, instruments, point coagulation, and vascularity of the tissues) probably play a role in the outcome. UROLOGY 69: 366-368, 2007.

Outcome of urethrocutaneous fistula repair after hypospadias surgery

Bangladesh Medical Journal Khulna, 2020

Background: Urethrocutaneous fistula is the most prevalent complication after urethroplasty. Many methods have been developed for correction, and the best technique is determined based on the size, location, and number of fistulas, as well as the status of the surrounding skin. Objective: To compare the outcome of local dartos flap and tunnelled tunica vaginalis coverage in cases of repair of urethrocutaneous fistula. Materials and Methods: In the period of 2015-2018, 51 patients with 51 fistulas with an average age of 81.3 months (range 21-156 months) were classified into coronal-19, distal penile-11, mid penile-14, proximal penile-5 and penoscrotal-2. Thirty six patients were repaired with local dartos flap coverage and 15 patients were repaired with tunnelled tunica vaginalis coverage. Results: The repair was successful in all patients of tunica vaginalis coverage but 7 patients of dartos flap coverage developed recurrent fistulas (p value 0.066). There was no patient of scrotal ...

Management of urethrocutaneous Fistula after hypospadias Repair: experience in 164 cases

Rawal Medical Journal, 2012

Objectives: To describe the results of managing urethrocutaneous fistulae after hypospadias surgery in children highlighting the best choice of repair. Patients and methods: Retrospectively we reviewed the medical records of one hundred and sixty four (164) patients, age ranged from two to fifteen years underwent repair of urethrocutaneous fistulae complicating hypospadias surgery in one year period;2006. Fistulae was simple and single in 98 cases (60%), less than 5mm, moderate size (>5mm) and multiple in 62 (38%) and severe, giant fistulae in 4 cases (2%). Regarding the frequency of their site most of the fistulae were at the corona, then penile shaft and the least were penoscrotal. The gap between primary hypospadias repair and the first attempt at fistula repair was 6 to12 months. Simple, single fistulae were repaired using a multilayer easy closure technique, and large fistulae repaired using rotating and advancement skin flaps. Cystocath diversion was used in all patients wi...