Fistula recurrence after urethrocutaneous fistulectomy in children with hypospadias: risk factors

Abstract

To study the risk factors of recurrence after primary urethrocutaneous fistulectomy in children with hypospadias. In the period from 2009 to 2019 sixty-three patients underwent a urethrocutaneous fistulectomy after hypospadias repair in our hospital. Patients were divided into two groups: group 1, patients with successful urethrocutaneous fistulectomy 51 (81.0 %) and group 2, children who had a failed urethrocutaneous fistulectomy 12 (19.0%). The study was analyzed retrospectively, according to the demographic factors of the patients, findings of the previous urethroplasty and location, type, meatal stenosis, postoperative stricture, and size of the urethrocutaneous fistula. All data were statistically analyzed on SPSS. The overall success rate of primary fistula repair was 81.0% (51 of 63 fistulae). Most recurrences (8 of 12 fistulas, 66.6%) occurred in fistula at the penoscrotal area. Demographic factors show no difference between the two groups age (p=0.501), weight (p=0.063), low body weight (p=0.454), BMI (p=0.924) and prematurity (p=0.381). Types of hypospadias (p = 0.007) and urethral defect length (p = 0.021) were identified by Student’s t-test as independent risk factors for failed outcome. Other factors such as meatal stenosis (p=0.431), postoperative stricture (p=0.587), location of the fistula (p=0.173), multiplicity (p=0.588) and size (p=0.530), were performed by Chi-square test and they also not significant. Type of hypospadias and urethral defect length are significant risk factors of secondary fistula recurrence after primary urethrocutaneous fistulectomy.