A lower fistula rate in hypospadias surgery

Gapany, Christophe; Grasset, Nicolas; Tercier, Stéphane; Ramseyer, Pascal; Frey, Peter; Meyrat, Blaise

doi:10.1016/j.jpurol.2006.12.003

Cited by 18 publications

(16 citation statements)

References 12 publications

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“…Local or systemic, adjuvant or neoadjuvant hormonal therapy has been proposed to reduce fistula development, but the results are controversial so far. Also, some of the postoperative care including the use of particular types of dressing and surgical material, wound status, and antibiotics should be considered [17]. These postoperative factors were excluded in our study and may play an important role as risk factors; henceforth, we will need to add these factors in our follow-up studies.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for the Development of Urethrocutaneous Fistula after Hypospadias Repair: A Retrospective Study

et al. 2012

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PurposeThe purpose of this study was to investigate the risk factors for urethrocutaneous fistula development after hypospadias repair.Materials and MethodsBetween January 1990 and May 2010, 348 patients underwent hypospadias repair. This study included 294 patients who were followed up for more than 6 months. Potential risk factors for the development of fistula after operation included age, location of hypospadias, type of hypospadias repair, suture materials and methods, methods and duration of catheterization, combined congenital urologic disorders, timing of presentation and repair of fistula, and location of fistula. Data were analyzed retrospectively. Binary logistic regression analysis was used for univariate and multivariate analysis.ResultsOut of 294 patients, 63 patients (21.4%, 63/294) developed urethrocutaneous fistulas after hypospadias repair. In the univariate analysis, fistula formation was statistically related with type of hypospadias and type of hypospadias repair. In the multivariate analysis with stratification by hypospadias site, however, only the location of hypospadias was a significant independent risk factor in urethrocutaneous fistula development after hypospadias repair (p<0.001).ConclusionsOur results suggest that the risk of developing urethrocutaneous fistula after hypospadias repair is associated with the location of hypospadias (more proximal-type hypospadias). Type of hypospadias repair, suture materials, suture techniques, and number of other combined urologic disorders were not related to the development of urethrocutaneous fistulas.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for the Development of Urethrocutaneous Fistula after Hypospadias Repair: A Retrospective Study

et al. 2012

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“…In contrast to the TIP technique, MEMO does not require urethral tubularization; hence, the risk of fistula formation is very low. A recently published review reported a fistula rate of 26% using a modified Duplay or Duplay-Snodgrass procedure [21]. Using a vascularized subcutaneous preputial tissue their fistula rate dropped to 3.5%.…”

Section: Discussionmentioning

confidence: 99%

“…However, besides mere surgical outcome data additional measures rating patients' satisfaction as well as an objective functional assessment are needed to evaluate thoroughly this new technique [18,19]. Moreover, data on objective patient reporting as well as quality of life data are scarce [20][21][22][23][24]. The present study uses a validated instrument, the Hypospadias Objective Scoring Evaluation (HOSE), for objective functional and cosmetic assessment of penile appearance [25].…”

Section: Introductionmentioning

confidence: 99%

Objective long-term evaluation after distal hypospadias repair using the meatal mobilization technique

Seibold

Werther

Alloussi

et al. 2010

Scandinavian Journal of Urology and Nephrology

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“…[19][20][21][22] The fistula rate in large hypospadias studies seems to vary from 0 to 33%. 23 Failure, fistula, and meatal stenosis are the most common complications encountered and they most likely to develop within 6 months postoperatively. 6,24,29 Although most recent hypospadias repairs show a low rate of complications, fistula formation remains an important problem.…”

Section: Discussionmentioning

confidence: 99%

Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

2017

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Background: Hypospadias is a relatively common congenital defect of the male external genitalia. The objective of this study was to evaluate whether the early removal of urethral stent following TIP Snodgrass repair of hypospadias can reduces postoperative complications of this procedure.Methods: In Al-Yarmouk teaching hospital, the surgical procedure included 61 tabularized incised plate (TIP) repairs for penile hypospadias. The patients were prospectively observed over 36 months and randomized into 2 groups, group (A) was 30 patients where the urethral stent was removed after 24 hours of operation, and group (B) was 31 cases where the stent removed in the 6th postoperative day. Suprapubic urinary diversion was done for all patients. All of the operations were performed by the same surgeon. Complications and cosmetic appearance were documented at last follow-up.Results: The average age of the patients was 3.9 years, urethrocutaneous fistula was observed in 2 cases in group A (6.6 %), while 11 patients had fistula in group B (35.4 %) with a statistically significant difference (p < 0.05). meatal stenosis was reported in 4 patients in (group A) (13.3%), while 12 patients had such complication in group B (38.7%) with a statistically Significant difference as (P< 0.05). 6.6 % of group A developed wound infection, while 32.2 % had wound infection postoperatively in group B with a statistically significant difference (P< 0.05). Complete surgical failure when wound dehiscence occurs, it was found that no significant difference between the 2 groups (P value=0.1).Conclusions: TIP repair is a versatile operation that can be performed in almost all cases of penile hypospadias. We believe that early stent removal after 1 day of surgery for hypospadias repair simplifies postoperative care, highly reduces risk of development of urethrocutaneous fistula, meatal stenosis and wound infection, so obviates the need for antibiotics.

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A lower fistula rate in hypospadias surgery

Cited by 18 publications

References 12 publications

Risk Factors for the Development of Urethrocutaneous Fistula after Hypospadias Repair: A Retrospective Study

Risk Factors for the Development of Urethrocutaneous Fistula after Hypospadias Repair: A Retrospective Study

Objective long-term evaluation after distal hypospadias repair using the meatal mobilization technique

Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

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