Aim: To investigate factors affecting urethrocutaneous fistula and meatal stenosis in repairing hypospadias through tubularized incised plate urethroplasty in children and the effects of magnifying loupes in preventing urethrocutaneous fistula and meatal stenosis.
Material and Methods: Operated with tubularized incised plate urethroplasty due to hypospadias between 2008-2016; 130 patients were retrospectively evaluated for age, type of hypospadias, associated anormalies, chordee, complication rate, magnifying loupes, and urethral catheterization and hospitalization times.
Results: At mean intraoperative age (IQR) of 3 (4.5) years (5months-15years), 130 patients were enrolled. Of 130 cases, 103 children had distal hypospadias, including seven as glanular, 60 as coronal, 13 as megameatus, and 23 as subcoronal, and 27 had proximal hypospadias, including 20 as midshaft and seven penoscrotal hypospadias. Twenty-five patients were younger than one year. Magnifying loupes (2.5X) were used in 55 cases. In 14 patients, four with urethrocutaneous fistula, seven with meatal stenosis, two with urethrocutaneous fistula and meatal stenosis, and one diagnosed with meatal stenosis and glans dehiscence, reintervention was required. For urethrocutaneous fistula and meatal stenosis: age (≤1y versus ˃1y), type of hypospadias (distal versus proximal), associated anomalies, and chordee had no effects on outcome, whereas magnifying loupes affected the outcome significantly in univariate and logistic regression analyses. We found no other statistical difference in factors likely to causesuch a difference in outcome, including age, type of hypospadias, associated anormalies, and chordee, when comparing the 55 and 75 cases performed with and without loupe.
Conclusion: Using magnifying loupes is effective in preventing urethrocutaneous fistula and meatal stenosis after tubularized incised plate urethroplasty in children with hypospadias.