Non-stented versus stented urethroplasty for distal hypospadias repair: A systematic review and meta-analysis

Chua, Michael; Welsh, Christopher; Amir, Bisma; Silangcruz, Jan Michael; Ming, Jessica M.; Gnech, Michele; Sanger, Stephanie; Lorenzo, Armando J.; Braga, Luis H.; Bägli, Darius

doi:10.1016/j.jpurol.2017.11.023

Cited by 20 publications

(12 citation statements)

References 30 publications

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“…The absence of urethral stent did not compromise the postoperative recovery in distal and mid-penile hypospadias repair. This was similar to the findings of a recent systematic review (54). Furthermore, a decreased incidence of bladder spasm and stent-related urinary infection using stentless repair was also reported (40,55).…”

Section: Discussionsupporting

confidence: 90%

Complications Following Primary Repair of Non-proximal Hypospadias in Children: A Systematic Review and Meta-Analysis

Wang

Zhao

et al. 2020

Front. Pediatr.

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Purpose: The aim of this study was to systematically review the literature on the complications and postoperative outcomes of children with non-proximal hypospadias.Methods: Electronic databases including PubMed, Embase, and Cochrane Library CENTRAL were searched systematically from January 1990 to June 2020 for the literature that reported the postoperative outcomes of patients with non-proximal hypospadias. Non-proximal hypospadias encompassed distal and mid-penile hypospadias.Results: We included 44 studies involving 10,666 subjects. Urethrocutaneous fistula (UCF) was the most common complication with an incidence of 4.0% (95% CI, 3.1–5.0%). Incidence of overall complications was 8.0% (95% CI, 6.3–9.8%). Meta-regression analysis revealed that length of urethral stent indwelling (coefficient 0.006; 95% CI, 0.000–0.011; p = 0.036) and penile dressing (coefficient 0.010; 95% CI, 0.000–0.021; p = 0.048) were two risk factors for UCF. Multivariate meta-regression analysis did not identify any independent risk factors for UCF. No differences were found between stent and stentless groups in non-proximal hypospadias regarding incidences of UCF (OR, 0.589; 95% CI, 0.267–1.297), meatal stenosis (OR, 0.880; 95% CI, 0.318–2.437), and overall complications (OR, 0.695; 95% CI, 0.403–1.199). No differences were found between foreskin preservation and circumcision in terms of complications either.Conclusions: UCF is the most common complication following hypospadias repair with an incidence of 4.0%. Independent risk factors for UCF were not identified in the current research. Distal hypospadias repair without stent indwelling is not likely to compromise the postoperative outcome. Further studies should be designed to explore the differences between different surgical approaches and the potential risk factors for complications following hypospadias repair.

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Section: Discussionsupporting

confidence: 90%

Complications Following Primary Repair of Non-proximal Hypospadias in Children: A Systematic Review and Meta-Analysis

Wang

Zhao

et al. 2020

Front. Pediatr.

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“…In a recent systematic review and meta-analysis comparing stented and non-stented distal hypospadias repair for TIPU and Mathieu techniques, there was no significant difference in the occurrence of early and late complication [16]. In a prospective and controlled study, similar results were presented [4].…”

Section: Discussionmentioning

confidence: 77%

Use of a Stent in Distal Hypospadias Repaired by Tubularized Incised Plate Urethroplasty: A Comparative Study

Karakaya¹,

Doğan

Güler

2019

Urol Int

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Purpose: We present our experience of stented and unstented distal hypospadias repaired by tubularized incised plate urethroplasty (TIPU). Patients and Methods: Data of 84 patients who were operated by TIPU method in 2 hospitals were retrospectively analyzed, and they were invited to be included in the study. Sixty-six patients agreed to participate in the study and were divided into 2 groups. Group 1 consisted of 38 boys operated in Sütçü İmam University Hospital on using a stent between 2015 and 2017. Group 2 consisted of 28 boys operated in Private Hospital of Megapark on without a stent between 2016 and 2017. The hypospadias objective scoring evaluation (HOSE) scale was used to compare the groups. Results: The median age was 2.81 years in group 1 and 1.95 years in group 2 (p = 0.243). The mean follow-up duration was 25.74 ± 4.62 and 24.5 ± 4.19 months in groups 1 and 2 respectively (p = 0.268). The HOSE scores were similar in both groups with comparable results (p = 0.622). Conclusions: No difference was observed between the groups in this study, regarding functional and cosmetic outcomes according to the HOSE score. However, the results should be supported by prospective studies with a sufficient number of patients.

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“…The 20 recent articles [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] on meta-analyses were published in the JPUrol between October 9, 2017, and May 17, 2021. Of these, only seven [19][20][21][22][23][24][25] were included for the calculation of FI.…”

Section: Resultsmentioning

confidence: 99%

Fragility Index of Recently Published Meta-Analyses in Pediatric Urology: A Striking Observation

Anand¹,

Kainth²

2021

Cureus

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Background and objectiveFragility Index (FI) of meta-analyses determines their stability in terms of the level of confidence and strength behind the results depicted by them. The present study was conducted to estimate the FI of recently published meta-analyses in the Journal of Pediatric Urology (JPUrol). MethodTwenty recently published articles on meta-analyses were screened to identify the eligible ones. The baseline data of each meta-analysis including the details of the author, number of included studies, total sample size, the total number of events, the status of the overall outcome (significant or non-significant), type of effect measure, type of method used for pooling the estimates, and type of effects model were recorded. FI was calculated by doing each single status modification. The 95% CI of the treatment effect was re-calculated until the statistical significance of the meta-analysis was reversed. ResultsA total of seven articles incorporating 22 meta-analyses were included. Seven (32%) of them had a statistically significant outcome prior to FI estimation. The risk ratio (17/22; 77%) was the most commonly used effect measure. The random-effects model (15/22; 68%) and the Mantel-Haenszel method (20/22; 91%) of pooling the estimates were utilized in the majority of meta-analyses. The median (Q1-Q3; range) FI of statistically significant, non-significant, and total meta-analyses were 5 (3-19.5; 2-39), 5 (3.5-6; 1-17), and 5 (3-13; 1-39) respectively. FI of ≤5 was noticed in four out of seven (57%), 9/15 (60%), and 13/22 (59%) of these meta-analyses respectively. ConclusionBased on our findings, the majority of the recently published meta-analyses in the field of pediatric urology are fragile and depend upon the event status of ≤5 participants.

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Non-stented versus stented urethroplasty for distal hypospadias repair: A systematic review and meta-analysis

Cited by 20 publications

References 30 publications

Complications Following Primary Repair of Non-proximal Hypospadias in Children: A Systematic Review and Meta-Analysis

Complications Following Primary Repair of Non-proximal Hypospadias in Children: A Systematic Review and Meta-Analysis

Use of a Stent in Distal Hypospadias Repaired by Tubularized Incised Plate Urethroplasty: A Comparative Study

Fragility Index of Recently Published Meta-Analyses in Pediatric Urology: A Striking Observation

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