Incidence of Urethrocuteanous Fistula after Primary Hypospadias Repair: A Meta-Analysis Study

Document Type : Review Article

Authors

1 Department of Plastic Surgery, Elsahel Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt

2 Department of Plastic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Abstract

Background: Hypospadias affects approximately one in every 200–300 male live births. The most frequent complication after hypospadias repair is urethrocutaneous fistula, even in experienced hands.
Purpose: To provide an updated meta-analysis of the global incidence of urethrocutaneous fistula after primary hypospadias repair using different techniques.
Methods: The authors searched PubMed, Scopus, Web of Science [WOS], Cochrane, Embase, Medline, and Google Scholar from January 2016 to January 2022 using relevant keywords. The reference lists of full-text articles identified through the search were also checked to identify any potentially eligible studies. This study screened 110 studies, of which 15 fulfilled the eligibility criteria for inclusion in the final meta-analysis.
Results: A total of 2040 cases mentioned 287 urethrocutaneous fistula events, with a percentage of 14.068% [ranging from 11.012 to 18.05], significant heterogeneity [p-value <0.0001], and an I2 of 75.72% [inconsistency] with a 95% CI for I2 of 59.95 – 85.28. To our knowledge, this is the highest reported incidence of urethrocutaneous fistula after primary hypospadias repair compared to previous studies.
Conclusion: Urethrocutaneous fistula is the most frustrating complication after hypospadias repair; therefore, this meta-analysis review was designed to provide a pooled estimate of the updated and near-accurate incidence of urethra-cutaneous fistula after primary repair. These study findings could be important for surgeons and health personnel to consider during the preoperative period.

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