PROGNOSTIC FACTORS FOR URETHROCUTANEOUS FISTULA IN CHILDREN WITH HYPOSPADIAS POST URETHROPLASTY IN DR.

SARDJITO GENERAL HOSPITAL, YOGYAKARTA

Teddy Soemijarto1, Leecarlo Millano1, Rochadi2 1. Pediatric Surgery Resident, Dept of Surgery-Subdivision Pediatric Surgery, RSUP Dr. Sardjito, Jogjakarta 2. Pediatric Surgery Consultant, Dept of Surgery-Subdivision Pediatric Surgery, RSUP Dr. Sardjito, Jogjakarta

Background Hypospadias are one of the most common congenital anomalies of newborn boys, occurring in approximately 3 to 5 per 1000 live births. Urethrocutaneous fistula is the most common complication with an incidence of 10% to 15% from all complications. Objective To analyze the prognostic factors that influence urethrocutaneous fistula for children with hypospadias post urethroplasty in our institution. Method We reviewed medical records of 88 patients that underwent urethroplasty procedure for hypospadias using a cohort retrospective study to identify prognostic factors for urethrocutaneous fistula from January 2009 to December 2012. The factors were analyzed using chi square (univariate analysis) with level of significance p<0.05. Result The variables potentially affecting the outcome were reviewed, including: age when the operation was done, haemoglobin level, nutritional status, leukocyte count, preoperative and postoperative serum albumin, type of operator (consultants or residents), type of hypospadias, length of operation, and length of hospitalization. None of these variables were associated with the outcome of urethrocutaneous fistula. Interestingly, phenoscrotal type was the most type with the outcome of fistula postoperative 9 (10.3%), followed with coronal, 6 (6.9%), midshaft penile, 5 (5.7%), distal penile, 3 (3.4%) and scrotal, 3 (3.4%). The length of hospitalization <16 days and length of operation <141 minutes had protective effects toward urethrocutaneous fistula with RR 0,48 (95% CI 0.189-1.259), RR 0.900 (95% CI 0.351-2.305) respectively. Conclusion This preliminary study adds data on the incidence of urethrocutaneous fistula posturethroplasty and studies with larger sample size should be done to further analyze the potential risk factors. Key Word Prognostic factors, urethrocutaneous fistula, post operation complication of hypospadias, Dr. Sardjito General Hospital