Work

Association between penile ischemia duration and complications after hypospadias repair in children

Year: 2026

Type: article

Abstract: Introduction: Clinical evidence regarding the impact of intraoperative penile ischemia during pediatric hypospadias repair remains inconclusive. Although experimental studies suggest that ischemia-reperfusion injury may impair wound healing, clinical data on the relationship between ischemia duration and postoperative outcomes in children are limited. This study aimed to determine whether the duration of intraoperative penile ischemia is associated with postoperative complications-specifically urethral fistula formation and meatal stenosis-in patients undergoing primary hypospadias repair. Methods: We conducted a retrospective, single-center cohort study of pediatric patients who underwent primary hypospadias repair with intraoperative penile tourniquet application over a 12-year period. The primary outcome was the occurrence of postoperative complications, specifically meatal stenosis or urethral fistula, requiring revision surgery. Secondary analyses assessed tourniquet duration, patient demographics, and key perioperative variables to identify potential risk factors for adverse outcomes. Results: = 0.15). No significant differences were observed in operative time, biometric variables, hypospadias severity, suture material, stenting duration, or postoperative hospital stay. Mean follow-up was 76 months. A structured literature review revealed that ischemia duration is inconsistently reported across studies, limiting comparability. Conclusions: Intraoperative penile ischemia duration within the mid-range commonly applied in clinical practice was not associated with an increased risk of postoperative fistula or meatal stenosis following primary hypospadias repair. These findings support the safety of standard penile tourniquet use during routine surgical procedures. However, prospective studies with standardized documentation of ischemia duration are needed to establish evidence-based safety thresholds and to further clarify potential ischemia-reperfusion effects.

Source: Frontiers in Pediatrics

DOI: 10.3389/fped.2026.1763150

Authors: Malin Dönig, Volker Sander, Ralf-Bodo Tröbs, Jochen Hubertus, Matthias Nissen

Institutions: Marien Hospital Witten, Gemeinschaftskrankenhaus Herdecke, Ruhr University Bochum, St. Vincenz-Krankenhaus Limburg

Language: English

Topic: Urological Disorders and Treatments

Subfield: Urology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801