Risk factors for postoperative complications in children with proximal hypospadias with severe chordee who underwent urethral plate transection

Objectives To identify the risk factors associated with developing complications after transection of the urethral plate for proximal hypospadias with severe chordee. Methods We used a prospective database to identify patients with proximal hypospadias and severe chordee who underwent transection of...

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Bibliographic Details
Published in:International journal of urology 2022-11, Vol.29 (11), p.1310-1314
Main Authors: Zhou, Guanglun, Wang, Ruifeng, Zhu, Wenbin, Yin, Jianchun, Yang, Zhilin, Li, Shoulin
Format: Article
Language:English
Subjects:
Child
Complications
Dehiscence
Humans
hypospadias
Hypospadias - surgery
Infant
Male
Postoperative
postoperative complications
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Postoperative Complications - surgery
Risk Factors
Surgeons
Treatment Outcome
Urethra - surgery
Urologic Surgical Procedures, Male - adverse effects
Urologic Surgical Procedures, Male - methods
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Summary:Objectives To identify the risk factors associated with developing complications after transection of the urethral plate for proximal hypospadias with severe chordee. Methods We used a prospective database to identify patients with proximal hypospadias and severe chordee who underwent transection of the urethral plate and primary hypospadias repair in 2011 and 2021. All patients underwent urethroplasty with a follow‐up period of >12 months. The association between variables (age, surgical technique, length of urethral defect, and surgeon volume) and postoperative complications (fistulas, urethral strictures, diverticula and glans dehiscence) was analyzed. Results Altogether, 493 patients were included, of whom 133 (26.9%) had postoperative complications. Univariate and multivariate analyses revealed that the preoperative proximal meatal position, one‐stage repair, longer urethral defect length, and low surgeon volume were significant risk factors for postoperative complications with proximal hypospadias with severe chordee who underwent transection of the urethral plate. A urethral defect length of ≥4.55 cm was considered the best cutoff value for predicting postoperative complications. Conclusions Preoperative proximal meatal location, one‐stage repair, longer urethral defect length, and low surgeon volume were associated with postoperative complications in patients with proximal hypospadias with severe chordee who underwent transection of the urethral plate. A urethral defect length of ≥4.55 cm was significantly associated with the development of complications.
ISSN:0919-8172
1442-2042
DOI:10.1111/iju.14986