title: Retrospective analysis of individual risk factors for urethrocutaneous fistula after onlay hypospadias repair in pediatric patients.
abstract: BACKGROUND
  To retrospectively identify the individual risk factors for the urethrocutaneous fistula (UCF) in pediatric patients after hypospadias repair (HR) with onlay island flap urethroplasty.
  
  
  METHODS
  A total of 167 patients who underwent primary HR at Nanjing Medical University Affiliated Children Hospital from January 2009 to December 2012 were enrolled. Clinical data including the patient' age at HR, hypospadias type and urethral defect length were documented.
  
  
  RESULTS
  Among 167 patients, 12.6% patients (n = 21) developed UCF after HR. Postoperative UCF occurred in 3.9% (3/76) cases at age of 0-2 years, 14.3% (9/63) at 2-4 years, 20.0% (2/10) at 4-6 years and 38.9% (7/18) at 6-12 years. The incidences of UCF were 12.0% (3/25), 11.4% (5/132) and 30.0% (3/10) for distal, middle and proximal types of hypospadias. As to the urethral defect length, the incidences of UCF were 8.2% (5/61) in patients with a length of ≤ 2 cm, 12.8% (9/70) in 2-3 cm, 22.6% (7/31) in 3-4 cm and 0% (0/5) in above 4 cm. Older age at HR was significantly associated with the high incidence of UCF formation (P = 0.004), while the hypospadias type and urethral defect length did not affect it (P = 0.264 and P = 0.312, respectively).
  
  
  CONCLUSIONS
  The patient' age at HR was a risk factor for the UCF formation after HR, and treatment of HR within two years old might be with the least incidence of UCF.
authors.affiliation: Department of Urology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210008, China. huangliqv@163.com.
authors.forename: Li-Qu
authors.initials: LQ
authors.lastname: Huang
authors.affiliation: Department of Urology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210008, China. sail_1198@hotmail.com.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Ge
authors.affiliation: Department of Urology, Beijing Children's Hospital Affiliated Hospital of Capital Medical University, Beijing, 100045, China. tianjimiao@sohu.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Tian
authors.affiliation: Department of Urology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210008, China. mgeng888@sina.com.
authors.forename: Geng
authors.initials: G
authors.lastname: Ma
authors.affiliation: Department of Urology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210008, China. doctorlu962@126.com.
authors.forename: Ru-Gang
authors.initials: RG
authors.lastname: Lu
authors.affiliation: Department of Urology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210008, China. dengyongji@gmail.com.
authors.forename: Yong-Ji
authors.initials: YJ
authors.lastname: Deng
authors.affiliation: Department of Urology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210008, China. cocowang003@163.com.
authors.forename: Li-Xia
authors.initials: LX
authors.lastname: Wang
authors.affiliation: Department of Urology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210008, China. dennies1@163.com.
authors.forename: Chen-Jun
authors.initials: CJ
authors.lastname: Chen
authors.affiliation: Department of Urology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210008, China. zhbneo@163.com.
authors.forename: Hao-Bo
authors.initials: HB
authors.lastname: Zhu
authors.affiliation: Department of Urology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210008, China. zhuxj851121@163.com.
authors.forename: Xiao-Jiang
authors.initials: XJ
authors.lastname: Zhu
authors.affiliation: Department of Urology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210008, China. guozhaooso@163.com.
authors.forename: Yun-Fei
authors.initials: YF
authors.lastname: Guo
mesh_terms: D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000453:epidemiology*; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D012307:Risk Factors; D013524:Surgical Flaps; D014522:Urethral Diseases / Q000453:epidemiology*; D014548:Urinary Fistula / Q000453:epidemiology*; D013521:Urologic Surgical Procedures, Male