Incidence of urethrocutaneous fistula formation during the first three postoperative months period of hypospadias reconstruction surgeries
DOI:
https://doi.org/10.56056/amj.2023.211Keywords:
Hypospadias, Postoperative complication, Urethro-cutaneous fistula, Tourniquet timeAbstract
Background and objectives: Urethrocutaneous fistula is one of the most frequent complications of hypospadias reconstructive surgeries. This study aimed to find the rate of fistula development following different types of reconstructive surgeries and their risk factors.
Method: This study was conducted at Hawler teaching hospital, Rizgary teaching hospital, and Zheen international hospital in Erbil – Iraq from September 2020 to March 2021. A total number of 39 patients who underwent single-step surgery for reconstruction of hypospadias were included in this study and they were followed up for the first three months postoperatively for post-operative complications especially urethrocutaneuos fistula development.
Results: Four patients out of thirty-nine developed urethral-cutaneous fistula (10.3%). A statistically significant relation was found between those aged older than 5 years and the rate of fistula development (three out of ten) (p-value = 0.023). Also, tourniquet time during the operation had a statistically significant relation with the incidence of fistula formation (mean time < 17.66 vs. > 20.5 minutes) in the fistula free vs. fistula group respectively (p =0.046).
Conclusion: Reconstructive surgeries for hypospadias at earlier ages and with as short as possible tourniquet time reduce the incidence of fistula formation post-operatively.
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References
Springer A, Van Den Heijkant M, Baumann S. Worldwide prevalence of hypospadias. J Pediatric Urol. 2016;12(3):152-e1.
Nordenvall AS, Frisén L, Nordenström A, Lichtenstein P, Nordenskjöld A. Population-based nationwide study of hypospadias in Sweden, 1973 to 2009: incidence and risk factors. J Urol. 2014;191(3):783-9.
Alan WP, Roger RD, Louis RK, Craig AP, Campbell-Walsh-Wein Urology: twelfth edition: Elsevier. 2020: 905-45.
Snodgrass W, Bush N. Tabularized incised plate proximal hypospadias repair: continued evolution and extended applications. J Pediatr Urol. 2011;7(1):2-9.
Eassa W, Jednak R, Capolicchio JP, Brzezinski A, El-Sherbiny M. Risk factors for re-operation following tubularized incised plate urethroplasty: a comprehensive analysis. Urology. 2011;77(3):716-20.
Hardwicke JT, Bechar JA, Hodson J, Osmani O, Park AJ. Fistula after single-stage primary hypospadias repair–a systematic review of the literature. J Plast Reconstr Aesthet Surg. 2015;68(12):1647-55.
Jumbi T, Shahbal S, Mugo R, Osawa F, Mwika P, Lessan J. Urethro-cutaneous fistula after hypospadias repair: a single institution study. Annals of African Surgery. 2019;16(2).
Richter F, Pinto PA, Stock JA, Hanna MK. Management of recurrent urethral fistulas after hypospadias repair. Urology. 2003;61(2):448-51.
Chung JW, Choi SH, Kim BS, Chung SK. Risk factors for the development of urethrocutaneous fistula after hypospadias repair: a retrospective study. Korean J Urol. 2012;53(10):711.
Elbakry A. Management of urethrocutaneous fistula after hypospadias repair: 10 years experience. BJU Int. 2001;88(6):590-5.
Baskin L. Hypospadias: a critical analysis of cosmetic outcomes using photography. . BJU Int. 2001;87(6):534-9.
Kirkali Z. Tunica vaginalis: an aid in hypospadias surgery. British J Urol. 990;65(5):530-2.
Cimador M, Castagnetti M, Milazzo M, Sergio M, De Grazia E. Suture materials: do they affect fistula and stricture rates in flap urethroplasties? Urol Int. 2004;73(4):320-4.
Fattah JH, Kakahmed HA, Al-Ibraheem NP. Outcome of Snodgrass urethroplasty by modifying tubularization and dartos layer in Erbil. Zanco J Med Sci. 2017;21(2):1715-21.
Sheng X, Xu D, Wu Y, Yu Y, Chen J, Qi J. The risk factors of urethrocutaneous fistula after hypospadias surgery in the youth population. BMC urology. 2018;18(1):1-6.
Huang LQ, Ge Z, Tian J, et al. Retrospective analysis of individual risk factors for urethrocutaneous fistula after on lay hypospadias repair in pediatric patients. Ital J Pediatric. 2015; 41: 35, 1-4.
Yildiz T, Tahtali IN, Ates DC, Keles I, Ilce Z. Age of patient is a risk factor for urethrocutaneous fistula in hypospadias surgery. J Pediatric Urol. 20131;9(6):900-3.
Hensle TW, Tennenbaum S, Reiley EA, Pollard J. Hypospadias repair in adults: adventures and misadventures. J Urol. 2001; 165:77–9.
Snodgrass WT, Bush N, Cost N. Tabularized incised plate hypospadias repair for distal hypospadias. J Pediatric Urol. 2010;6(4):408-13.
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