Lesser evaluated determinants of fistula formation in children with hypospadias

Determinants of fistula formation, some of them not previously evaluated, w ere studied in 30 consecutive children admitted for hypospadias repair to o ur centre. All children were screened for any urinary or local infections. Vicryl and catgut were used alternately for reconstruction of the neo-ureth ra, Per urethral drainage was employed in all patients. The presence of unf avourable local anatomical factors, the surgeon's satisfaction at the end o f the procedure and duration of surgery were noted. The patients were follo wed up for any urethrocutaneous fistula. Unsatisfactory surgery (chi-square =6.53, p=0.01), unfavourable anatomical factors (chi-square=10.80, p=0.001) and local infection (chi-square=5.66, p=0.017) had a strong association wi th fistula formation, whereas urine leakage and a history of previous surge ry had only a marginal association. On application of stepwise binary logis tic regression, unfavourable local anatomical factors (OR [95% CI], 13.19 [ 1.20-143.50]) and urine leakage (OR [95% CI]: 14.35 [1.20-171.45]) emerge a s strong risk factors for urethrocutaneous fistula, and local infection (OR [95% CI], 8.70 (0.93-81.01]) as a moderate risk factor.