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Preoperative illnesses do not increase risk of complications after hypospadias repair

11 Feb 2019

Children with preoperative illnesses, such as common cold, are not at increased risk for postoperative complications, according to a recent study. Preoperative illnesses that are not severe enough to postpone surgery may even have a protective effect, particularly for postoperative infections.

“Consequently, there is no reason to alter preoperative screening,” the authors said.

A total of 681 boys were included, of whom 22 percent had preoperative illnesses and 14 percent had postoperative complications. Children with preoperative illnesses had fewer postoperative complications within 2 months (n=13; 9 percent) than those without preoperative illnesses (n=79; 16 percent), resulting in a 50-percent risk reduction (odds ratio [OR], 0.49; 95 percent CI, 0.26–0.93).

Of note, preoperative infections (eg, common cold, fever and ear infection) were associated with a lower risk of postoperative infections, including wound and urinary tract infections (OR, 0.37; 0.14–0.98). Results for complications were similar within 1 year.

This retrospective cohort study obtained data from 681 children with anterior or middle-type hypospadias that had initial 1-stage repair in the period 1983–2012 in The Netherlands.

Multivariable logistic regression analyses were used to analyse 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 1 year after surgery.

“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,” the authors noted.

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