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. 2020 Dec 9:8:579364.
doi: 10.3389/fped.2020.579364. eCollection 2020.

Complications Following Primary Repair of Non-proximal Hypospadias in Children: A Systematic Review and Meta-Analysis

Yuhao Wu  1   2 , Junke Wang  1   2 , Tianxin Zhao  1   2 , Yuexin Wei  1   2 , Lindong Han  1   2 , Xing Liu  1   2 , Tao Lin  1   2 , Guanghui Wei  1   2 , Shengde Wu  1   2
Affiliations

Complications Following Primary Repair of Non-proximal Hypospadias in Children: A Systematic Review and Meta-Analysis

Yuhao Wu et al. Front Pediatr. .

Abstract

Purpose: The aim of this study was to systematically review the literature on the complications and postoperative outcomes of children with non-proximal hypospadias. Methods: Electronic databases including PubMed, Embase, and Cochrane Library CENTRAL were searched systematically from January 1990 to June 2020 for the literature that reported the postoperative outcomes of patients with non-proximal hypospadias. Non-proximal hypospadias encompassed distal and mid-penile hypospadias. Results: We included 44 studies involving 10,666 subjects. Urethrocutaneous fistula (UCF) was the most common complication with an incidence of 4.0% (95% CI, 3.1-5.0%). Incidence of overall complications was 8.0% (95% CI, 6.3-9.8%). Meta-regression analysis revealed that length of urethral stent indwelling (coefficient 0.006; 95% CI, 0.000-0.011; p = 0.036) and penile dressing (coefficient 0.010; 95% CI, 0.000-0.021; p = 0.048) were two risk factors for UCF. Multivariate meta-regression analysis did not identify any independent risk factors for UCF. No differences were found between stent and stentless groups in non-proximal hypospadias regarding incidences of UCF (OR, 0.589; 95% CI, 0.267-1.297), meatal stenosis (OR, 0.880; 95% CI, 0.318-2.437), and overall complications (OR, 0.695; 95% CI, 0.403-1.199). No differences were found between foreskin preservation and circumcision in terms of complications either. Conclusions: UCF is the most common complication following hypospadias repair with an incidence of 4.0%. Independent risk factors for UCF were not identified in the current research. Distal hypospadias repair without stent indwelling is not likely to compromise the postoperative outcome. Further studies should be designed to explore the differences between different surgical approaches and the potential risk factors for complications following hypospadias repair.

Keywords: children; complications; hypospadias; meta-analysis; surgery.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol recommendations.
Figure 2
Figure 2
Forest plot of incidence of urethrocutaneous fistula following hypospadias repair.
Figure 3
Figure 3
Forest plot of incidence of meatal stenosis following hypospadias repair.
Figure 4
Figure 4
Forest plot of incidence of meatal retraction following hypospadias repair.
Figure 5
Figure 5
Forest plot of incidence of wound dehiscence following hypospadias repair.
Figure 6
Figure 6
Forest plot of incidence of overall complications following hypospadias repair.
Figure 7
Figure 7
Forest plot of incidence of reoperation following hypospadias repair.
Figure 8
Figure 8
Univariate meta-regression analysis indicates that length of penile dressing (A) and urethral stent indwelling (B) are the risk factors leading to urethrocutaneous fistula (UCF).
See this image and copyright information in PMC

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References

    1. Baskin LS. Hypospadias and urethral development. J Urol. (2000) 163:951–6. 10.1016/S0022-5347(05)67861-5 - DOI - PubMed
    1. Subramaniam R, Spinoit AF, Hoebeke P. Hypospadias repair: an overview of the actual techniques. Semin Plast Surg. (2011) 25:206–12. 10.1055/s-0031-1281490 - DOI - PMC - PubMed
    1. Duarsa GWK, Dau DO, Pramana IBP, Tirtayasa PMW, Yudiana IW, Santosa KB, et al. . Risk factors for urethrocutaneous fistula following hypospadias repair surgery in Indonesia. J Pediatr Urol. (2020) 12:175–8. 10.2147/RRU.S249734 - DOI - PubMed
    1. Long CJ, Chu DI, Tenney RW, Morris AR, Weiss DA, Shukla AR, et al. . Intermediate-term followup of proximal hypospadias repair reveals high complication rate. J Urol. (2017) 197:852–8. 10.1016/j.juro.2016.11.054 - DOI - PMC - PubMed
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analysis: the PRISMA statement. Ann Intern Med. (2009) 151:264–9. 10.7326/0003-4819-151-4-200908180-00135 - DOI - PubMed

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