A multicenter study on surgical procedure selection and risk factor analysis of postoperative complications after TIP and Duckett hypospadias repair
Abstract Background Hypospadias is a common congenital malformation in pediatric urology with surgery being the only curative treatment. Although there are hundreds of surgical methods for hypospadias, no single method can treat all types, and there are still high rates of postoperative complication...
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-08-01
|
| Series: | BMC Urology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12894-022-01051-2 |
| _version_ | 1817998773784150016 |
|---|---|
| author | YiWei Fang Ning Sun HongCheng Song WeiPing Zhang YunMan Tang LuGang Huang Yi Yang Min Chao Hong Ma JingTi Zhang XuHui Zhang ShouLin Li Ning Li Chao Chen DaWei He WenBo Wu Hua Xie Yong Guan |
| author_facet | YiWei Fang Ning Sun HongCheng Song WeiPing Zhang YunMan Tang LuGang Huang Yi Yang Min Chao Hong Ma JingTi Zhang XuHui Zhang ShouLin Li Ning Li Chao Chen DaWei He WenBo Wu Hua Xie Yong Guan |
| author_sort | YiWei Fang |
| collection | DOAJ |
| description | Abstract Background Hypospadias is a common congenital malformation in pediatric urology with surgery being the only curative treatment. Although there are hundreds of surgical methods for hypospadias, no single method can treat all types, and there are still high rates of postoperative complications. We performed this study to investigate surgical procedure selection and perform risk factor analysis of postoperative complications in hypospadias repair. Methods Retrospective analysis was performed of complete clinical and follow-up data of children with hypospadias who were treated and followed up at 15 children’s clinical centers in Mainland China from December 2018 to December 2019. Children were divided into groups according to Barcat classification and surgical methods in order to analyze the surgical choice for different types of hypospadias and the influencing factors of different surgical methods for complications. Results In total, 1011 patients were followed up for 26 months. According to Barcat classification, there were 248 cases of distal type hypospadias, 214 of intermediate, and 549 of proximal type. Transverse preputial island flap urethroplasty (Duckett) and tubularized incised plate urethroplasty (TIP) were performed in 375 (37.1%) and 336 cases (33.2%), respectively. The postoperative complication rate of distal hypospadias was 23.4% (15.8–57.1%), mid shaft 29.0% (22.7–40.0%), and proximal 43.7% (30.2–52.9%). Among the 375 patients in Duckett group, 192 had complications. Multivariate logistic analysis showed that the length of prepuce island flap (OR = 3.506, 95% CI: 2.258–5.442) was an independent risk factor for complications after Duckett operation (P < 0.001). In TIP group, there were 336 cases with 84 complications. Multivariate logistic analysis showed that the width of urethral plate after longitudinal resection (OR = 0.836, 95% CI: 0.742–0.942) and glans width (OR = 0.851, 95% CI: 0.749–0.965) were independent risk factors for postoperative complications after TIP (P = 0.003, P = 0.012). Conclusion Several anatomical features play a role during the selection process among the different surgical approaches, including glans size, urethral plate width, and the meatal position. The width of the urethral plate and glans width were risk factors for postoperative complications after TIP. The length of prepuce island flap was a risk factor for complications after Duckett operation. |
| first_indexed | 2024-04-14T02:57:45Z |
| format | Article |
| id | doaj.art-396fb1e8060c41268e57928fca788ffe |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-04-14T02:57:45Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-396fb1e8060c41268e57928fca788ffe2022-12-22T02:16:00ZengBMCBMC Urology1471-24902022-08-012211810.1186/s12894-022-01051-2A multicenter study on surgical procedure selection and risk factor analysis of postoperative complications after TIP and Duckett hypospadias repairYiWei Fang0Ning Sun1HongCheng Song2WeiPing Zhang3YunMan Tang4LuGang Huang5Yi Yang6Min Chao7Hong Ma8JingTi Zhang9XuHui Zhang10ShouLin Li11Ning Li12Chao Chen13DaWei He14WenBo Wu15Hua Xie16Yong Guan17Department of Urology, National Center for Children’s Health, Beijing Children’s Hospital of Capital Medical UniversityDepartment of Urology, National Center for Children’s Health, Beijing Children’s Hospital of Capital Medical UniversityDepartment of Urology, National Center for Children’s Health, Beijing Children’s Hospital of Capital Medical UniversityDepartment of Urology, National Center for Children’s Health, Beijing Children’s Hospital of Capital Medical UniversityDepartment of Pediatric Surgery, Department of Pediatric Surgery, Sichuan Academy of Medical Sciences – Sichuan Provincial People’s Hospital (SAMSPH)Department of Pediatric Surgery, West China Hospital of Sichuan UniversityDepartment of Pediatric Urology, Shengjing Hospital of China Medical UniversityDepartment of Pediatric Urology, Anhui Children’s HospitalDepartment of Pediatric Urology and General Thoracic Surgery, Affiliated Hospital of Zunyi Medical UniversityDepartment of Urology, Xi’an Children’s HospitalDepartment of Urology, Shanxi Children’s HospitalDepartment of Urology, Shenzhen Children’s HospitalDepartment of Pediatric Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & TechnologyDepartment of Pediatric Urology, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Urology, Children’s Hospital of Chongqing Medical UniversityDepartment of Urology, Children’s Hospital of Jiangxi ProvinceDepartment of Urology, Shanghai Children’s HospitalDepartment of Urology, Tianjin Children’s HospitalAbstract Background Hypospadias is a common congenital malformation in pediatric urology with surgery being the only curative treatment. Although there are hundreds of surgical methods for hypospadias, no single method can treat all types, and there are still high rates of postoperative complications. We performed this study to investigate surgical procedure selection and perform risk factor analysis of postoperative complications in hypospadias repair. Methods Retrospective analysis was performed of complete clinical and follow-up data of children with hypospadias who were treated and followed up at 15 children’s clinical centers in Mainland China from December 2018 to December 2019. Children were divided into groups according to Barcat classification and surgical methods in order to analyze the surgical choice for different types of hypospadias and the influencing factors of different surgical methods for complications. Results In total, 1011 patients were followed up for 26 months. According to Barcat classification, there were 248 cases of distal type hypospadias, 214 of intermediate, and 549 of proximal type. Transverse preputial island flap urethroplasty (Duckett) and tubularized incised plate urethroplasty (TIP) were performed in 375 (37.1%) and 336 cases (33.2%), respectively. The postoperative complication rate of distal hypospadias was 23.4% (15.8–57.1%), mid shaft 29.0% (22.7–40.0%), and proximal 43.7% (30.2–52.9%). Among the 375 patients in Duckett group, 192 had complications. Multivariate logistic analysis showed that the length of prepuce island flap (OR = 3.506, 95% CI: 2.258–5.442) was an independent risk factor for complications after Duckett operation (P < 0.001). In TIP group, there were 336 cases with 84 complications. Multivariate logistic analysis showed that the width of urethral plate after longitudinal resection (OR = 0.836, 95% CI: 0.742–0.942) and glans width (OR = 0.851, 95% CI: 0.749–0.965) were independent risk factors for postoperative complications after TIP (P = 0.003, P = 0.012). Conclusion Several anatomical features play a role during the selection process among the different surgical approaches, including glans size, urethral plate width, and the meatal position. The width of the urethral plate and glans width were risk factors for postoperative complications after TIP. The length of prepuce island flap was a risk factor for complications after Duckett operation.https://doi.org/10.1186/s12894-022-01051-2Proximal hypospadiasTabularized incised plateVentral curvatureUrethroplasty |
| spellingShingle | YiWei Fang Ning Sun HongCheng Song WeiPing Zhang YunMan Tang LuGang Huang Yi Yang Min Chao Hong Ma JingTi Zhang XuHui Zhang ShouLin Li Ning Li Chao Chen DaWei He WenBo Wu Hua Xie Yong Guan A multicenter study on surgical procedure selection and risk factor analysis of postoperative complications after TIP and Duckett hypospadias repair BMC Urology Proximal hypospadias Tabularized incised plate Ventral curvature Urethroplasty |
| title | A multicenter study on surgical procedure selection and risk factor analysis of postoperative complications after TIP and Duckett hypospadias repair |
| title_full | A multicenter study on surgical procedure selection and risk factor analysis of postoperative complications after TIP and Duckett hypospadias repair |
| title_fullStr | A multicenter study on surgical procedure selection and risk factor analysis of postoperative complications after TIP and Duckett hypospadias repair |
| title_full_unstemmed | A multicenter study on surgical procedure selection and risk factor analysis of postoperative complications after TIP and Duckett hypospadias repair |
| title_short | A multicenter study on surgical procedure selection and risk factor analysis of postoperative complications after TIP and Duckett hypospadias repair |
| title_sort | multicenter study on surgical procedure selection and risk factor analysis of postoperative complications after tip and duckett hypospadias repair |
| topic | Proximal hypospadias Tabularized incised plate Ventral curvature Urethroplasty |
| url | https://doi.org/10.1186/s12894-022-01051-2 |
| work_keys_str_mv | AT yiweifang amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT ningsun amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT hongchengsong amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT weipingzhang amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT yunmantang amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT luganghuang amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT yiyang amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT minchao amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT hongma amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT jingtizhang amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT xuhuizhang amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT shoulinli amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT ningli amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT chaochen amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT daweihe amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT wenbowu amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT huaxie amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT yongguan amulticenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT yiweifang multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT ningsun multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT hongchengsong multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT weipingzhang multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT yunmantang multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT luganghuang multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT yiyang multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT minchao multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT hongma multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT jingtizhang multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT xuhuizhang multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT shoulinli multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT ningli multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT chaochen multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT daweihe multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT wenbowu multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT huaxie multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair AT yongguan multicenterstudyonsurgicalprocedureselectionandriskfactoranalysisofpostoperativecomplicationsaftertipandducketthypospadiasrepair |