Journal of pediatric surgery · 2026
Multiple relaxing short incisions significantly reduce urethral fistula after hypospadias repair: A retrospective cohort study.
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Cao Hualin, Yi Xiaoyu, Tao Tian, Zhao Yang, Wu Yangyang, Zhang Xiaowei, Jia Hongshuai, Jin Ruyue, Ye Weijing, Zhou Huixia, Li Pin
Аннотация
PURPOSE: The study aimed to assess the safety, efficacy, and reproducibility of the multiple relaxing short incisions (MRSI) technique in hypospadias repair.
METHODS: This retrospective cohort study included 316 patients with hypospadias who used the MRSI technique (group MRSI) or not (group traditional) in hypospadias surgery between September 2020 and September 2023. A comparison was made between the two groups regarding the penis skin cosmetic outcomes and the occurrence of complications such as urethral fistula, wound infection, glans dehiscence, urethral stricture, and urethral diverticulum.
RESULTS: Among 316 patients, 139 were assigned into group MRSI while 177 were into group traditional. TIP was performed on 169 patients, inlay with TIP on 82 patients, and onlay island flap urethroplasty on 65 patients. The postoperative complication rate was significantly lower in group MRSI than in group traditional (P = 0.009). Group MRSI presented 3 cases of urethral fistula, with one concurrent wound infection, resulting in a ratio of 2.16%. In contrast, group traditional had 15 cases of urethral fistula, with 8 concurrent wound infections, yielding a ratio of 8.47%. The occurrence of urethral fistula in group MRSI was significantly lower than in group traditional (P = 0.025). Multivariable logistic regression confirmed that MRSI was independently associated with a reduced risk of fistula (OR = 0.081; 95% CI: 0.010-0.372; P = 0.005). No significant differences were observed between the two groups in terms of wound infection, glans dehiscence, urethral stricture, urethral diverticulum, and penile skin cosmetic score.
CONCLUSION: MRSI technique decreases the occurrence of urethral fistula complications following hypospadias repair in patients with identifiable skin tension, providing a safe, effective, and reproducible method with favorable cosmetic results.
METHODS: This retrospective cohort study included 316 patients with hypospadias who used the MRSI technique (group MRSI) or not (group traditional) in hypospadias surgery between September 2020 and September 2023. A comparison was made between the two groups regarding the penis skin cosmetic outcomes and the occurrence of complications such as urethral fistula, wound infection, glans dehiscence, urethral stricture, and urethral diverticulum.
RESULTS: Among 316 patients, 139 were assigned into group MRSI while 177 were into group traditional. TIP was performed on 169 patients, inlay with TIP on 82 patients, and onlay island flap urethroplasty on 65 patients. The postoperative complication rate was significantly lower in group MRSI than in group traditional (P = 0.009). Group MRSI presented 3 cases of urethral fistula, with one concurrent wound infection, resulting in a ratio of 2.16%. In contrast, group traditional had 15 cases of urethral fistula, with 8 concurrent wound infections, yielding a ratio of 8.47%. The occurrence of urethral fistula in group MRSI was significantly lower than in group traditional (P = 0.025). Multivariable logistic regression confirmed that MRSI was independently associated with a reduced risk of fistula (OR = 0.081; 95% CI: 0.010-0.372; P = 0.005). No significant differences were observed between the two groups in terms of wound infection, glans dehiscence, urethral stricture, urethral diverticulum, and penile skin cosmetic score.
CONCLUSION: MRSI technique decreases the occurrence of urethral fistula complications following hypospadias repair in patients with identifiable skin tension, providing a safe, effective, and reproducible method with favorable cosmetic results.