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Published on: January 7, 2019
Analysis of factors associated with postoperative complications after primary hypospadias repair: a retrospective
Zirong He1, Bo Yang1, Yunman Tang1
1Department of Pediatric Surgery of Children's Medical Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital & Affiliated Hospital of the University of Electronic Science and Technology of China, Chengdu, China.
Insights
Postoperative constipation is a significant risk factor for complications after primary hypospadias repair. Strengthening defecation management during the perioperative period can help reduce these adverse events in pediatric patients.
Area of Science:
- Pediatric Surgery
- Urology
- Clinical Research
Background:
- Hypospadias repair in children has a high rate of postoperative complications.
- Identifying risk factors for these complications is crucial for improving surgical outcomes.
Purpose of the Study:
- To identify independent risk factors for postoperative complications following primary hypospadias repair in pediatric patients.
Main Methods:
- Retrospective analysis of 857 children undergoing primary hypospadias repair.
- Data collected included patient demographics, surgical variables, and postoperative outcomes.
- Multivariate logistic regression was used to analyze risk factors for complications.
Main Results:
- Postoperative complications occurred in 11.2% of patients.
- Postoperative constipation was identified as an independent risk factor for complications (OR=1.793, P=0.027).
- Other factors analyzed included hypospadias type, operation time, and reconstructed urethra length.
Conclusions:
- Postoperative constipation significantly increases the risk of complications after primary hypospadias repair.
- Enhanced perioperative defecation management is recommended for hypospadias patients.
Background:
To determine the risk factors for postoperative complications after primary hypospadias repair. Hypospadias has a high postoperative complication rate, and the risk factors of postoperative complications have attracted extensive attention.
Methods:
A total of 857 children who received primary surgical repair for hypospadias in our center between 3 January 2017 and 29 January 2021 were retrospectively analyzed. The collected data included age at time of surgery, type of hypospadias, body mass index (BMI), surgeon, operation time, length of reconstructed urethra, method of anesthesia (general anesthesia or general anesthesia combined with caudal anesthesia), and postoperative constipation. The risk factors for postoperative complications were analyzed by multivariate analysis.
Results:
The follow-up time in this study was 6-54 months, with a mean follow-up time of 29 months. A total of 96 (11.2%) of the 857 pediatric patients had postoperative complications, including 44 (45.8%) cases of urethral fistula, 14 (14.6%) cases of urethral stricture, 5 (5.2%) cases of urethral diverticula, 5 (5.2%) cases of distal dehiscence, 3 (3.1%) cases of poor exposure, 2 (2.1%) cases of residual curvature, 1 (1.0%) case of penoscrotal transposition, 6 (6.3%) cases of urethral stricture and diverticulum, 6 (6.3%) cases of urethral fistula and diverticulum, 3 (3.1%) cases of urethral fistula and postoperative residual curvature, 2 (2.1%) cases of urethral fistula and distal dehiscence, and 1 (1.0%) case each of urethral fistula and transposition, urethral diverticulum and poor exposure, urethral stricture and poor exposure, distal dehiscence and transposition, and residual curvature and transposition. After univariate analysis, type of hypospadias (P=0.038), operation time (P<0.001), length of reconstructed urethra (P=0.007), and postoperative constipation (P=0.019) were included in the multivariate logistic regression analysis. The results showed that postoperative constipation was an independent risk factor for complications [P=0.027, odds ratio (OR) =1.793, confidence interval (CI): 1.067 to 3.012].
Conclusions:
Postoperative constipation is an important influencing factor for postoperative complications following primary hypospadias repair. Therefore, defecation management should be strengthened for hypospadias patients during the perioperative period.
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