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Postoperative outcomes in distal hypospadias : a meta-analysis of the Mathieu and tubularized incised plate repair methods for development of urethrocutaneous fistula and urethral stricture

Winberg, Hans LU ; Arnbjörnsson, Einar LU ; Anderberg, Magnus LU and Stenström, Pernilla LU (2019) In Pediatric Surgery International
Abstract

PURPOSE: To compare the two major complications, namely postoperative urethrocutaneous fistula and urethral stricture, between the Mathieu and tubularized incised plate (TIP) repair methods for distal hypospadias.

METHODS: In this meta-analysis, electronic databases were searched for comparative studies on the two techniques. The Oxford Centre for Evidence-based Medicine Levels of Evidence was used to evaluate the included studies. The main outcome measure was the frequency of postoperative fistula and urethral stricture. RevMan 5.3 was used for statistical analyses, with P < 0.05 indicating statistical significance.

RESULTS: A total of 17 studies, which included 1572 patients, met the inclusion criteria. The frequency of... (More)

PURPOSE: To compare the two major complications, namely postoperative urethrocutaneous fistula and urethral stricture, between the Mathieu and tubularized incised plate (TIP) repair methods for distal hypospadias.

METHODS: In this meta-analysis, electronic databases were searched for comparative studies on the two techniques. The Oxford Centre for Evidence-based Medicine Levels of Evidence was used to evaluate the included studies. The main outcome measure was the frequency of postoperative fistula and urethral stricture. RevMan 5.3 was used for statistical analyses, with P < 0.05 indicating statistical significance.

RESULTS: A total of 17 studies, which included 1572 patients, met the inclusion criteria. The frequency of urethrocutaneous fistula did not differ between the Mathieu [115 (13%)] and TIP [90 (13%)] methods [odds ratio (OR) 1.1, 95% confidence intervals (CI) 0.6-1.9; P = 0.73)]. Urethral stricture was less frequent after the Mathieu [15 (2%)] method than after the TIP [37 (5%)] method (OR 0.5, 95% CI 0.3-0.8; P < 0.01), even after the subgroup analysis of eight randomized controlled trials was included. Overall, the quality of the included studies was determined to be satisfactory. The levels of evidence on which this review was based ranged from 1b to 2b using the CEBM Levels of Evidence.

CONCLUSION: Compared with TIP repair, Mathieu repair for hypospadias had a significantly lower risk for urethral stricture; however, the risk for urethrocutaneous fistula was similar.

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Pediatric Surgery International
publisher
Springer
ISSN
1437-9813
DOI
10.1007/s00383-019-04523-z
language
English
LU publication?
yes
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e6f458f9-8300-40f4-859e-eaabf87d0677
date added to LUP
2019-08-05 22:28:44
date last changed
2019-08-06 11:31:06
@article{e6f458f9-8300-40f4-859e-eaabf87d0677,
  abstract     = {<p>PURPOSE: To compare the two major complications, namely postoperative urethrocutaneous fistula and urethral stricture, between the Mathieu and tubularized incised plate (TIP) repair methods for distal hypospadias.</p><p>METHODS: In this meta-analysis, electronic databases were searched for comparative studies on the two techniques. The Oxford Centre for Evidence-based Medicine Levels of Evidence was used to evaluate the included studies. The main outcome measure was the frequency of postoperative fistula and urethral stricture. RevMan 5.3 was used for statistical analyses, with P &lt; 0.05 indicating statistical significance.</p><p>RESULTS: A total of 17 studies, which included 1572 patients, met the inclusion criteria. The frequency of urethrocutaneous fistula did not differ between the Mathieu [115 (13%)] and TIP [90 (13%)] methods [odds ratio (OR) 1.1, 95% confidence intervals (CI) 0.6-1.9; P = 0.73)]. Urethral stricture was less frequent after the Mathieu [15 (2%)] method than after the TIP [37 (5%)] method (OR 0.5, 95% CI 0.3-0.8; P &lt; 0.01), even after the subgroup analysis of eight randomized controlled trials was included. Overall, the quality of the included studies was determined to be satisfactory. The levels of evidence on which this review was based ranged from 1b to 2b using the CEBM Levels of Evidence.</p><p>CONCLUSION: Compared with TIP repair, Mathieu repair for hypospadias had a significantly lower risk for urethral stricture; however, the risk for urethrocutaneous fistula was similar.</p>},
  author       = {Winberg, Hans and Arnbjörnsson, Einar and Anderberg, Magnus and Stenström, Pernilla},
  issn         = {1437-9813},
  language     = {eng},
  month        = {08},
  publisher    = {Springer},
  series       = {Pediatric Surgery International},
  title        = {Postoperative outcomes in distal hypospadias : a meta-analysis of the Mathieu and tubularized incised plate repair methods for development of urethrocutaneous fistula and urethral stricture},
  url          = {http://dx.doi.org/10.1007/s00383-019-04523-z},
  year         = {2019},
}