Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures
Background Polyglactin (PG) and polydioxanone (PDS) sutures are extensively used based on the surgeon’s preference. The development of post-reconstruction urethrocutaneous fistula (UCF) is variably attributed to the choice of suture material for urethroplasty. This meta-analysis compares complicatio...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-01-01
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| Series: | World Journal of Pediatric Surgery |
| Online Access: | https://wjps.bmj.com/content/7/1/e000659.full |
| _version_ | 1797229045825404928 |
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| author | C K Sinha Tridip Dutta Baruah Nitinkumar Borkar Charu Tiwari Debajyoti Mohanty Manoj Mohanty |
| author_facet | C K Sinha Tridip Dutta Baruah Nitinkumar Borkar Charu Tiwari Debajyoti Mohanty Manoj Mohanty |
| author_sort | C K Sinha |
| collection | DOAJ |
| description | Background Polyglactin (PG) and polydioxanone (PDS) sutures are extensively used based on the surgeon’s preference. The development of post-reconstruction urethrocutaneous fistula (UCF) is variably attributed to the choice of suture material for urethroplasty. This meta-analysis compares complications of hypospadias repair using PG and PDS sutures.Methods The systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors conducted thorough searches in databases including MEDLINE, EMBASE, CENTRAL, Scopus, Google Scholar, and clinical trial registries. Outcome measures included UCF, meatal stenosis, wound infection, urethral stricture, glans dehiscence, and overall complications. Quantitative analysis was used with fixed or random-effect models to find the pooled risk ratio and I2 heterogeneity.Results The criteria for inclusion were met by five comparative studies with the inclusion of 1244 children altogether. Pooled analysis failed to show a statistically significant difference in the incidence of meatal stenosis, urethral stricture, wound infection, and total complications using PG and PDS sutures. However, it showed a reduction in the incidence of UCF with PDS suture hypospadias repairs (risk ratio=0.66, 95% CI 0.48 to 0.92).Conclusions PDS sutures are associated with decreased incidence of UCF than PG after hypospadias repair. The incidence of meatal stenosis, urethral stricture, wound infection, and total complications was not affected by the type of suture material used for repair.Clinical implications This meta-analysis suggests decreased incidence of UCF when PDS sutures are used for hypospadias repair which may impact the choice of suture material for repair.PROSPERO registration number CRD42023409710. |
| first_indexed | 2024-03-07T18:59:26Z |
| format | Article |
| id | doaj.art-68a1496b9a794fabaf3d32918a62daea |
| institution | Directory Open Access Journal |
| issn | 2516-5410 |
| language | English |
| last_indexed | 2024-04-24T15:06:21Z |
| publishDate | 2024-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | World Journal of Pediatric Surgery |
| spelling | doaj.art-68a1496b9a794fabaf3d32918a62daea2024-04-02T13:05:15ZengBMJ Publishing GroupWorld Journal of Pediatric Surgery2516-54102024-01-017110.1136/wjps-2023-000659Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin suturesC K Sinha0Tridip Dutta Baruah1Nitinkumar Borkar2Charu Tiwari3Debajyoti Mohanty4Manoj Mohanty5Paediatric Surgery, St George`s University Hospitals NHS Foundation Trust, London, UKGeneral Surgery, All India Institute of Medical Sciences-Raipur, Raipur, Chhattisgardh, IndiaPaediatric Surgery, All India Institute of Medical Sciences-Raipur, Raipur, Chhattisgardh, IndiaPaediatric Surgery, All India Institute of Medical Sciences-Raipur, Raipur, Chhattisgardh, IndiaGeneral Surgery, All India Institute of Medical Sciences-Raipur, Raipur, Chhattisgardh, IndiaPediatric Surgery, All India Institute of Medical Sciences-Bhubaneswar, Bhubaneswar, Orissa, IndiaBackground Polyglactin (PG) and polydioxanone (PDS) sutures are extensively used based on the surgeon’s preference. The development of post-reconstruction urethrocutaneous fistula (UCF) is variably attributed to the choice of suture material for urethroplasty. This meta-analysis compares complications of hypospadias repair using PG and PDS sutures.Methods The systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors conducted thorough searches in databases including MEDLINE, EMBASE, CENTRAL, Scopus, Google Scholar, and clinical trial registries. Outcome measures included UCF, meatal stenosis, wound infection, urethral stricture, glans dehiscence, and overall complications. Quantitative analysis was used with fixed or random-effect models to find the pooled risk ratio and I2 heterogeneity.Results The criteria for inclusion were met by five comparative studies with the inclusion of 1244 children altogether. Pooled analysis failed to show a statistically significant difference in the incidence of meatal stenosis, urethral stricture, wound infection, and total complications using PG and PDS sutures. However, it showed a reduction in the incidence of UCF with PDS suture hypospadias repairs (risk ratio=0.66, 95% CI 0.48 to 0.92).Conclusions PDS sutures are associated with decreased incidence of UCF than PG after hypospadias repair. The incidence of meatal stenosis, urethral stricture, wound infection, and total complications was not affected by the type of suture material used for repair.Clinical implications This meta-analysis suggests decreased incidence of UCF when PDS sutures are used for hypospadias repair which may impact the choice of suture material for repair.PROSPERO registration number CRD42023409710.https://wjps.bmj.com/content/7/1/e000659.full |
| spellingShingle | C K Sinha Tridip Dutta Baruah Nitinkumar Borkar Charu Tiwari Debajyoti Mohanty Manoj Mohanty Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures World Journal of Pediatric Surgery |
| title | Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures |
| title_full | Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures |
| title_fullStr | Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures |
| title_full_unstemmed | Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures |
| title_short | Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures |
| title_sort | post urethroplasty complications in hypospadias repair a systematic review and meta analysis comparing polydioxanone and polyglactin sutures |
| url | https://wjps.bmj.com/content/7/1/e000659.full |
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