Tel-Aviv, Israel: A recent study published in the journal Urology has suggested that the presence and repair of meatal stenosis do not seem to affect the recurrence rate of urethrocutaneous fistulas repaired concomitantly after hypospadias repair.
Fistula formation and meatal stenosis are two of the most common complications of hypospadias repair. Hypospadias severity is the main predictor for the need for revision surgery, complications, and hypospadias repair. In the study, Yuval Bar-Yosef, Tel-Aviv University, Tel-Aviv, Israel, and colleagues aimed to evaluate whether concomitant treatment of meatal stenosis with urethral fistula repair alters the results of fistula closure in a retrospective cohort study.
The study included all children who underwent local fistula closure following hypospadias repair between 2006–2017. Those who underwent reoperative urethroplasty were not included. Researchers extracted data from electronic records and missing data were supplied by telephone interview. They also compared the characteristics of patients and fistulas between children who underwent fistula closure only and those who underwent meatoplasty for meatal stenosis during the same surgery. The primary endpoint was fistula recurrence.
Following were the study's key findings:
· In total, 106 local repairs of urethrocutaneous fistulas were performed during the study period, and 25 of them included concomitant meatoplasty for meatal stenosis.
· There was no difference in terms of location, size, and the number of fistulas or the number of recurrent fistulas between the 81 patients who underwent fistula closure only and the 25 who underwent concomitant meatoplasty.
· The fistula recurrence rate was 17/81 (21%) for the fistula-only group and 5/25 (20%) for the fistula and meatoplasty group after a median follow-up of 7 and 8 years, respectively.
· Meatoplasty was required in a subsequent procedure in 5/81 in the former group vs. 3/25 patients in the latter group.
Based on the results, the researchers concluded that concomitant repair of meatal stenosis and urethral fistula does not increase the risk of fistula recurrence post-hypospadias surgery.
Reference:
The study titled, "Concomitant repair of meatal stenosis and urethral fistula does not increase the risk of fistula recurrence post-hypospadias surgery," was published in the journal Urology.
DOI: https://doi.org/10.1016/j.urology.2021.11.029