Retrospective analysis of individual risk factors for urethrocutaneous fistula after onlay hypospadias repair in pediatric patients

Li-Qu Huang,Ru-Gang Lu,Zheng Ge,Hao-Bo Zhu,Chen-Jun Chen,Jun Tian,Yong-Ji Deng,Xiao-Jiang Zhu,Li-Xia Wang,Geng Ma,Yun-Fei Guo

doi:10.1186/s13052-015-0140-8

Abstract

BackgroundTo retrospectively identify the individual risk factors for the urethrocutaneous fistula (UCF) in pediatric patients after hypospadias repair (HR) with onlay island flap urethroplasty.MethodsA total of 167 patients who underwent primary HR at Nanjing Medical University Affiliated Children Hospital from January 2009 to December 2012 were enrolled. Clinical data including the patient’ age at HR, hypospadias type and urethral defect length were documented.ResultsAmong 167 patients, 12.6% patients (n = 21) developed UCF after HR. Postoperative UCF occurred in 3.9% (3/76) cases at age of 0–2 years, 14.3% (9/63) at 2–4 years, 20.0% (2/10) at 4–6 years and 38.9% (7/18) at 6–12 years. The incidences of UCF were 12.0% (3/25), 11.4% (5/132) and 30.0% (3/10) for distal, middle and proximal types of hypospadias. As to the urethral defect length, the incidences of UCF were 8.2% (5/61) in patients with a length of ≤ 2 cm, 12.8% (9/70) in 2-3 cm, 22.6% (7/31) in 3–4 cm and 0% (0/5) in above 4 cm. Older age at HR was significantly associated with the high incidence of UCF formation (P = 0.004), while the hypospadias type and urethral defect length did not affect it (P = 0.264 and P = 0.312, respectively).ConclusionsThe patient’ age at HR was a risk factor for the UCF formation after HR, and treatment of HR within two years old might be with the least incidence of UCF.

Highlights

To retrospectively identify the individual risk factors for the urethrocutaneous fistula (UCF) in pediatric patients after hypospadias repair (HR) with onlay island flap urethroplasty
There are several studies on the variables related to UCF after HR [13-17], data on the individual risk factors of pediatric patients developing UCF remain rare
Materials and methods The retrospective study enrolled a total of 167 pediatric patients who underwent primary HR with onlay island flap urethroplasty at Nanjing Children’s Hospital Affiliated to

Summary

Introduction

To retrospectively identify the individual risk factors for the urethrocutaneous fistula (UCF) in pediatric patients after hypospadias repair (HR) with onlay island flap urethroplasty. Despite more than 100 different types of HR operation [7], onlay island flap and tabularized incised plate urethroplasty (TIP) are the two most popular procedures of choice for HR [8]. Urethrocutaneous fistula (UCF) is still an important postoperative complications of onlay HR, and often occurs in 5%-10% of hypospadias cases [2,12,13], especially within one month after operation, affecting the surgical outcome [13,14]. There are several studies on the variables related to UCF after HR [13-17], data on the individual risk factors of pediatric patients developing UCF remain rare

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Results

Conclusion