The Impact of Postoperative Urinary Diversion on Surgical Outcomes of Hypospadias Repair: A Systematic Review and Meta-Analysis of Pediatric Literature
Abstract
1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Study Selection
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- Patient/Problem: Pediatric patients diagnosed with hypospadias (age ≤ 18 years).
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- Intervention: Hypospadias repair with urinary diversion (bladder catheter or urethral stent).
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- Comparison/Control: Hypospadias repair without urinary diversion (unstented procedures).
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- Outcome(s): Urethrocutaneous fistula/dehiscence rate, meatal/urethral stenosis rate, rate of other postoperative complications, diversion-related mechanical and functional complications, and re-operation rates.
2.3. Data Extraction
2.4. Study Endpoints
2.5. Risk of Bias Assessment
2.6. Statistical Analysis
3. Results
3.1. Study and Patient Characteristics
3.2. Urinary Diversion Types
3.3. Postoperative Outcomes
3.4. Meta-Analysis of Outcomes
3.4.1. Bladder Catheter vs. Urethral Stent
3.4.2. Stented vs. Unstented Procedures
3.4.3. Catheterization Length ≤ 5 Days vs. Catheterization Length > 5 Days
3.5. Publication Bias
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
PRISMA | Preferred Reporting Items for Systematic Reviews and Meta-analyses |
RCT | Randomized controlled trial |
UCF | Urethrocutaneous fistula |
AUR | Acute urinary retention |
OR | Odds ratio |
CI | Confidence interval |
WI | Wound infection |
UTI | Urinary tract infection |
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Escolino, M.; Caracò, M.S.; Mazzone, V.; Di Mento, C.; Carraturo, F.; Perricone, F.; Esposito, G.; Porcaro, M.; Esposito, C. The Impact of Postoperative Urinary Diversion on Surgical Outcomes of Hypospadias Repair: A Systematic Review and Meta-Analysis of Pediatric Literature. Medicina 2025, 61, 1659. https://doi.org/10.3390/medicina61091659
Escolino M, Caracò MS, Mazzone V, Di Mento C, Carraturo F, Perricone F, Esposito G, Porcaro M, Esposito C. The Impact of Postoperative Urinary Diversion on Surgical Outcomes of Hypospadias Repair: A Systematic Review and Meta-Analysis of Pediatric Literature. Medicina. 2025; 61(9):1659. https://doi.org/10.3390/medicina61091659
Chicago/Turabian StyleEscolino, Maria, Maria Sofia Caracò, Valerio Mazzone, Claudia Di Mento, Francesca Carraturo, Flavio Perricone, Giovanni Esposito, Mauro Porcaro, and Ciro Esposito. 2025. "The Impact of Postoperative Urinary Diversion on Surgical Outcomes of Hypospadias Repair: A Systematic Review and Meta-Analysis of Pediatric Literature" Medicina 61, no. 9: 1659. https://doi.org/10.3390/medicina61091659
APA StyleEscolino, M., Caracò, M. S., Mazzone, V., Di Mento, C., Carraturo, F., Perricone, F., Esposito, G., Porcaro, M., & Esposito, C. (2025). The Impact of Postoperative Urinary Diversion on Surgical Outcomes of Hypospadias Repair: A Systematic Review and Meta-Analysis of Pediatric Literature. Medicina, 61(9), 1659. https://doi.org/10.3390/medicina61091659