Preoperative Illnesses in Children Do Not Increase the Risk of Complications After Hypospadias Repair.

BACKGROUND

Preoperative illnesses might induce immunosuppression and subsequently increase morbidity after surgery. Several studies have tried to identify risk factors for complications after hypospadias correction, but effects of illnesses in the weeks just before surgery are unknown. We aimed to determine the associations between preoperative illnesses not severe enough to postpone surgery and short-term complications after hypospadias repair in children.

METHODS

In this retrospective cohort study, data were collected from 681 children with anterior or middle type hypospadias that had initial one-stage repair in the period 1983-2012 in the Radboudumc, The Netherlands. The associations between common illnesses, such as common cold, fever, and ear infection, within 2 weeks before repair, and postoperative complications, such as urethrocutaneous fistula, wound dehiscence, and stenosis, within 2 months and one year after surgery were analyzed using multivariable logistic regression analyses.

RESULTS

Of the 681 boys, 22% had preoperative illnesses, most often common cold, and 14% had postoperative complications. Children with preoperative illnesses had fewer postoperative complications within two months (n=13, 9%) than children without preoperative illnesses (n=79, 16%), resulting in a 50% risk reduction (OR 0.49, 95%CI 0.26-0.93). Preoperative infections (common cold, fever, ear infection) in particular reduced the risk of postoperative infections (wound and urinary tract infections) (OR 0.37, 95%CI 0.14-0.98). Results were similar for complications within one year.

CONCLUSIONS

Common preoperative illnesses not severe enough to postpone surgery did not increase the postoperative complication risk and even seemed to have a protective effect, especially for postoperative infections. Consequently there is no reason to alter preoperative screening.