Effect of anesthesia for hypospadias repair on perioperative complications

AIM The purpose of this retrospective cohort study was to assess the impact between caudal regional anesthesia, other regional anesthesia and no regional anesthesia on complications after hypospadias repair at a tertiary care children’s hospital in Ottawa, Canada, with an expectation to changing practices if a link was found.

METHOD We reviewed the health records of 827 children with hypospadias undergoing penile surgery from January 1991-June 2017. The final sample size for the analysis consisted of 764 patients and 825 procedures.

RESULTS The overall complications were almost identical when considering anesthesia effects, and this similarity persisted when we assessed specifically for only surgical complications. We had 716, 94 and 15 subjects that had a caudal block, penile block and general anesthesia only, respectively, and their complications rates were 28, 31 and 27%, respectively, and their fistula formation rates were 10, 6 and 0% respectively and their stricture formation rates were 8, 7, and 20%, respectively. Hypospadias type and surgical repair technique were marked predictors of complications in the postoperative period.

CONCLUSION Anesthesia technique appears to have minor impact on complications after hypospadias repair, while surgical technique and type of hypospadias impact complications after hypospadias surgery in children. Based upon these results, we will not change our current practice of using a variety of regional anesthesia techniques for children undergoing hypospadias repair.