Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures

BackgroundPolyglactin (PG) and polydioxanone (PDS) sutures are extensively used based on the surgeon’s preference. The development of post-reconstruction urethrocutaneous fistula (UCF) is variably attributed to the choice of suture material for urethroplasty. This meta-analysis compares complication...

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Bibliographic Details
Published in:World journal of pediatric surgery 2024, Vol.7 (1), p.e000659-e000659
Main Authors: Borkar, Nitinkumar, Tiwari, Charu, Mohanty, Debajyoti, Baruah, Tridip Dutta, Mohanty, Manoj, Sinha, C K
Format: Article
Language:English
Subjects:
Child Health
Comparative studies
Congenital Abnormalities
Data Collection
Epidemiology
Ethology
Fistula
Grey literature
Meta-analysis
Penis
Quantitative analysis
Surgery
Sutures
Systematic Review
Wound healing
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Summary:BackgroundPolyglactin (PG) and polydioxanone (PDS) sutures are extensively used based on the surgeon’s preference. The development of post-reconstruction urethrocutaneous fistula (UCF) is variably attributed to the choice of suture material for urethroplasty. This meta-analysis compares complications of hypospadias repair using PG and PDS sutures.MethodsThe systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors conducted thorough searches in databases including MEDLINE, EMBASE, CENTRAL, Scopus, Google Scholar, and clinical trial registries. Outcome measures included UCF, meatal stenosis, wound infection, urethral stricture, glans dehiscence, and overall complications. Quantitative analysis was used with fixed or random-effect models to find the pooled risk ratio and I2 heterogeneity.ResultsThe criteria for inclusion were met by five comparative studies with the inclusion of 1244 children altogether. Pooled analysis failed to show a statistically significant difference in the incidence of meatal stenosis, urethral stricture, wound infection, and total complications using PG and PDS sutures. However, it showed a reduction in the incidence of UCF with PDS suture hypospadias repairs (risk ratio=0.66, 95% CI 0.48 to 0.92).ConclusionsPDS sutures are associated with decreased incidence of UCF than PG after hypospadias repair. The incidence of meatal stenosis, urethral stricture, wound infection, and total complications was not affected by the type of suture material used for repair.Clinical implicationsThis meta-analysis suggests decreased incidence of UCF when PDS sutures are used for hypospadias repair which may impact the choice of suture material for repair.PROSPERO registration numberCRD42023409710.
ISSN:2516-5410
2096-6938
2516-5410
DOI:10.1136/wjps-2023-000659