Impact of Regional Analgesia on Postoperative Complications in Children Undergoing Urethroplasty for Distal Hypospadias Repair – A Retrospective Cohort Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: A BSTRACT Background: Surgery for hypospadias is usually performed under general anesthesia, with anesthesiologists employing caudal, epidural, and penile blocks to provide postoperative analgesia. Recent research suggests a possible association between increased incidence of complications (especially urethrocutaneous fistulae [UCFs]) and perioperative use of caudal blocks. The increased incidence of complications was attributed to the vasodilatation and penile engorgement following the regional block. The purpose of this study is to determine the overall incidence of complications following urethroplasty in our institute and determine if there is a causal association with neuraxial block. Methods: Electronic medical records of all children who underwent primary urethroplasty for distal hypospadias in our institutre from 2011 to 2020 were reviewed and statistical analysis done. Results: A total of 333 children with a mean age of 4.6 years were included in the study. Caudal block was given for 229 children and single-dose epidural for 32 children. Seventy-two children did not receive any regional block. The incidence of glanular dehiscence was 6% and UCF was 19% in neuraxial blocks compared to 3% and 15% in the other group ( P = 0.2 and 0.4). Multivariate regression analysis of level of hypospadias, severity of chordee, surgeon’s experience, and type of local anesthetic or additive used showed no other significant independent variable affecting the outcome. Conclusion: Postoperative urethral fistula formation was observed in children who received and did not receive neuraxial analgesia for urethroplasty surgery, with the incidence being marginally higher in the neuraxial block group.
Authors: Arun Kumar Loganathan, Ajay Ashok, Sampriti Das, Susan Jehangir, Anita Shirley Joselyn
Institution: Christian Medical College, Vellore
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411844419