Risk factors for urethrocutaneous fistula following hypospadias repair surgery in Indonesia

Duarsa, Gede Wirya Kusuma; Tirtayasa, Pande Made Wisnu; Daryanto, Besut; Nurhadi, Pradana; Renaldo, Johan; Tarmono,; Utomo, Trisula; Yuri, Prahara; Siregar, Safendra; Wahyudi, Irfan; Situmorang, Gerhard Reinaldi; Palinrungi, Muhammad Asykar; Hutasoit, Yonas Immanuel; Hutahaean, Andre Yudha Alfanius; Zulfiqar, Yevri; Sigumonrong, Yacobda; Mirza, Hendy; Rodjani, Arry; Kloping, Yudhistira Pradnyan

doi:10.1016/j.jpurol.2020.04.011

Cited by 22 publications

(30 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Age was a significant risk factors for UC fistula after hypospadias repair in Indonesia and about 60% of their patients were more than 4 years old [30]. However, Weber, et al did not find evidence to support recommendations concerning the ideal age for hypospadias repair [31].…”

Section: Discussionmentioning

confidence: 97%

Tabularised Incised Plate (TIP) Urethroplasty in Narrow V/S Wide Urethral Plate: A Comparative Study in a Developing Country Perspective

Walid¹,

Minhajuddin²,

Rajib³

et al. 2021

Arch of Pedia Surg

View full text Add to dashboard Cite

Introduction: Tubularized incised plate (TIP) urethroplasty is the most commonly performed operation for distal and mid shaft hypospadias. There are controversies in the previous reports regarding the association between urethral plate width and complications in TIP repair. The aim of this study was to compare the impact of urethral plate width in TIP repair on the development of complications in the perspective of a developing country.Methods: It was a prospective comparative study carried out in the department of pediatric surgery, Chittagong Medical College Hospital, Bangladesh from December, 2017 to March, 2019. Patients with distal and midshaft hypospadias were divided into 2 groups: Group A-urethral plate less than 8 mm wide and Group B-urethral plate 8 mm or more wide. Age at surgery, penile characteristics, pre-incision urethral plate width, per-operative factors and development of complications were analyzed. Follow up period ranged from 6 months to 2.5 years.Results: A total of 43 patients (21 in group A, 22 in group B), with a mean age of 6.67 ± 3.38 years underwent TIP repair. Twenty-five (58%) patients had distal penile and 18 (42%) had mid shaft hypospadias. Age correlated with glans size and urethral plate width (P = 0.019 and 0.003, respectively) but there was no significant difference in age between patients with or without development of complications (P = 0.71). Complications developed in 18 (41.87%) patients, 9 in each group. Mean urethral plate width was 7.37 ± 0.84 mm and 7.19 ± 1.17 mm in patients who had successful repair and those developed complications, respectively (P = 0.59). Duration of tourniquet, size of catheter, layers of repair, duration of dressing or catheter were not also associated with UC fistula, the most common complication (P = 0.26, 0.58,0.76, 0.38, and 0.56, respectively). Conclusion:Width of urethral plated was not related to development of complications in TIP repair. Complication rates were high in comparison to other studies and skill development and improvement of other factors are necessary in the developing world to improve outcome.

show abstract

Section: Discussionmentioning

confidence: 97%

Tabularised Incised Plate (TIP) Urethroplasty in Narrow V/S Wide Urethral Plate: A Comparative Study in a Developing Country Perspective

Walid¹,

Minhajuddin²,

Rajib³

et al. 2021

Arch of Pedia Surg

View full text Add to dashboard Cite

show abstract

“…12 The most recent study by Duarsa et al also concluded that percutaneous cystotomy could decrease the risk of urethrocutaneous fistula (odds ratio=2.963, p=0.014). 21 Our study suggests that posterior hypospadias, longer urethral defect and preoperative leucocyturia played a significant role in the formation of urethrocutaneous fistula. Similar to previous studies, posterior hypospadias was associated with urethrocutaneous fistula and reoperation after urethroplasty.…”

Section: Discussionmentioning

confidence: 55%

“…12 The most recent study by Duarsa et al also concluded that percutaneous cystotomy could decrease the risk of urethrocutaneous fistula (odds ratio=2.963, p =0.014). 21…”

Section: Discussionmentioning

confidence: 99%

Single-stage urethroplasty: An eight-year single-centre experience and its associated factors for urethrocutaneous fistula

Satjakoesoemah

Situmorang

Wahyudi

et al. 2020

Journal of Clinical Urology

Self Cite

View full text Add to dashboard Cite

Introduction: This study aimed to describe single-stage urethroplasty and to determine factors associated with urethrocutaneous fistula after the procedure at our institution. Methods: All hypospadias patients without any prior surgery who underwent single-stage urethroplasty from July 2010 to January 2018 were included. In total, 179 patients were followed for at least one year postoperatively. Information on types of hypospadias, operation techniques, chordee degree, preoperative pyuria (urine white blood cell count >5/HPF), urethral defect length and urethrocutaneous fistula formation was collected. Results: We obtained 103 cases of posterior (57.5%), middle (57 cases) and anterior (19 cases) hypospadias on whom onlay preputial island flap (71 cases), tubularized incised plate (46 cases) and Duckett’s transverse preputial island flap (35 cases) were conducted. After 47.1±25.8 months of follow-up, urethrocutaneous fistula were found in 23 (12.8%) patients associated with posterior hypospadias occurrence ( p=0.025), longer urethral defect ( p=0.007) and preoperative pyuria ( p<0.001). Chordee degree ( p=0.886) and age ( p=0.187) were not significant factors associated with urethrocutaneous fistula formation. Conclusion: Single-stage urethroplasty is a versatile procedure for various hypospadias cases, with a urethrocutaneous fistula rate of 12.8%. Posterior hypospadias, preoperative pyuria and longer urethral defect were associated with urethrocutaneous fistula formation. Level of evidence Level 2B.

show abstract

“…There is an increasing awareness of MIP as a rare hypospadias variant [ 9 ]. As a country with more than a quarter-billion people and 600 ethnicities with a rising report of hypospadias cases, this unique variant's report is highly necessary [ 6 ]. East Java, where the patient currently lives, is the second-largest province in Indonesia with a wide variety of socio-demographic backgrounds representative of the country [ 10 ].…”

Section: Clinical Discussionmentioning

confidence: 99%

“…This is highly important in countries like Indonesia, where circumcision is considered a common tradition based on religious and cultural reasons [ 5 ]. The case has never been previously reported in Indonesia, even though a recently published nationwide multicenter study showed many hypospadias cases in the country [ 6 ]. In addition to the encounter rarity, reconstruction of MIP is challenging as there is spongiosum deficiency resulting in a thin and immobile ventral portion of the urethral meatus tissue [ 7 ].…”

Section: Introduction and Importancementioning

confidence: 96%

Tubularized incised plate urethroplasty for megameatus intact prepuce hypospadias variant: First reported case in Indonesia

Permana

Djojodimedjo

Renaldo

2021

International Journal of Surgery Case Reports

Self Cite

View full text Add to dashboard Cite

Highlights Megameatus intact Prepuce (MIP) is a rare variant of hypospadias. The case has never been previously reported in Indonesia. MIP reconstruction is challenging due to a thin and immobile ventral portion of the urethral meatus tissue. Tubularized Incised Plate (TIP) urethroplasty is able to fulfil adequate outcomes for a MIP hypospadias variant. Telemedicine can be utilized for postoperative care in pediatric urology patients.

show abstract

Risk factors for urethrocutaneous fistula following hypospadias repair surgery in Indonesia

Cited by 22 publications

References 19 publications

Tabularised Incised Plate (TIP) Urethroplasty in Narrow V/S Wide Urethral Plate: A Comparative Study in a Developing Country Perspective

Tabularised Incised Plate (TIP) Urethroplasty in Narrow V/S Wide Urethral Plate: A Comparative Study in a Developing Country Perspective

Single-stage urethroplasty: An eight-year single-centre experience and its associated factors for urethrocutaneous fistula

Tubularized incised plate urethroplasty for megameatus intact prepuce hypospadias variant: First reported case in Indonesia

Contact Info

Product

Resources

About