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The Impact of Perioperative and Operative Variables on Early Postoperative Complications Following Primary Hypospadias Repair. Urology 2022 Dec;170:184-188

Date

08/16/2022

Pubmed ID

35970358

DOI

10.1016/j.urology.2022.08.002

Scopus ID

2-s2.0-85137697644 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

OBJECTIVE: To evaluate possible risk factors for complications following primary hypospadias repair relative to factors associated with timing of hypospadias repair in terms of case order, morning or afternoon scheduling, perioperative delays, and surgeon's daily work schedule as well as individual operative techniques.

METHODS: We retrospectively reviewed charts of 422 boys undergoing primary hypospadias repair with a sutured urethroplasty by 1 of 3 surgeons over a 10-year period and the surgeon's daily schedule.

RESULTS: The median age and IQR of the patients at time of operation was 0.79 (0.57) years, and median follow-up was 259 (664) days. A significant increase in the rate of any complication was noted with morning vs afternoon cases for the group overall with morning cases having a hazard 2.3 times higher than afternoon cases (P =.012). Additionally, there was a significant increase in hazard of complication with increasing difference in time between actual procedure duration vs scheduled duration, with hazard of complication increasing 5% for each increase of 15 minutes of surgical time (P =.043).

CONCLUSION: A variety of previously identified potential risk factors for hypospadias complications were identified. Our analysis also demonstrated variability in level of risk of different factors between surgeons, reinforcing the utility of surgeons monitoring their own results in response to changes in technique. Novel potential risk factors for some surgeons identified in our study included an increased risk of complications when the hypospadias was done in the morning rather than the afternoon and when the procedure lasted longer than scheduled.

Author List

Storm DW, Lockwood GM, Bonnett MA, Cooper BJ, Harris LM, Cooper CS

Author

Douglas W. Storm MD Chief, Professor in the Urology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Humans
Hypospadias
Infant
Male
Postoperative Complications
Retrospective Studies
Treatment Outcome
Urethra
Urologic Surgical Procedures, Male