Comparison of post-urethroplasty complication rates in pediatric cases with hypospadias using Vicryl or polydioxanone sutures

Objective:Hypospadias is a common congenital problem among male newborns.Both rapid absorbable sutures(polyglactin,Vicryl)and delayed absorbable sutures(polydioxanone,PDO)are used in hypospadias repair based on the surgeon's preference.This study was conducted to compare post-urethroplasty complication rates in pediatric patients with hypospadias using Vicryl or PDO sutures.Methods:This is a retrospective study which was designed and performed on 583 children aged 1-7 years old who had undergone hypospadias repair from January 2012 to December 2018.Required data were obtained from the patients'medical records.Results:Overall,post-surgical complications were observed in 60(10.3%)patients comprising urethro-cutaneous fistula(n=39,6.7%),meatal stenosis(n=10,1.7%),urethral stricture(n=7,1.2%),and glans dehiscence(n=4,0.7%).The mean age of the children with complications was 3.0±1.3 years.According to Kaplan-Meier estimate,the interval between surgery and development of complications was significantly shorter in the Vicryl group(p=0.037).Overall,complications were more prevalent in Vicryl suture than PDO suture(15.1%vs.5.3%,p<0.001).Regression model revealed that in comparison to the distal type,proximal hypospadias(odds ratio[OR]:103.9,95%confidence interval[CI]:32.2-334.9,p<0.001)and mid-shaft hypospadias(OR:82.9,95%CI:25.9-264.6,p<0.001)while using Vicryl suture instead of PDO suture(OR:62.4,95%CI:21.2-183.8,p<0.001)increased the odds of developing post-urethroplasty complications.Conclusion:We suggest PDO suture in the repair of hypospadias due to its lower complication rate,especially in cases of proximal and mid-shaft hypospadias which can get more complicated than the distal type.

A cross-sectional study of complementary and alternative medicine use in patients with coagulation disorders in Southern Iran

OBJECTIVE：Complementary and alternative medicine（CAM）use has an increasing trend around the world.Despite the wild application of CAM in patients with coagulation disorders,its efficacy is still questioned by many studies.The aim of this study was to determine the frequency and types of CAM usage,and the factors affecting CAM use among patients with bleeding disorders.METHODS：This cross-sectional study investigated the usage of CAM with a standard validated questionnaire in coagulopathic patients who were referred to Dastgheib Hospital,an educational therapeutic center affiliated to the Shiraz University of Medical Sciences in Shiraz,Southern Iran.RESULTS：Between December 2015 and May 2016,75 patients were included in this survey.Severe hemophilia A and rare bleeding disorders were the most frequent among our participants.Overall,nearly half of the studied population（49.3%）used at least one CAM product or practices.The most common products were multivitamin（29.3%）,followed by folic acid（21.3%）and chamomile（12%）.32%of the patients resorted to faith healing.The main reasons of using CAM were reported to be increased general health,correction of anemia and thrombocytopenia and control of bleeding tendency.CONCLUSION：CAM is being used frequently in patients with coagulation disorders like many other chronic illnesses all around the world.Due to emerging concern regarding the safety and possible interaction with the conventional medicine,it is necessary to develop basic data about the hematologic effects of these methods in order to use them more safely.