Tubularized incised plateurethroplasty and grafted tubularized incised plate urethroplasty: systematic review, metaanalysis and trial sequential analysis

Background Hypospadias is one of the most common genital birth defects.There are around 300 various techniques available for the repair of hypospadias.This study aims to compare the reported outcomes of Tubularized incised plate urethroplasty(TIP)and Grafted TIP(GTIP)repair in children undergoing primary hypospadiasrepair.Methods This meta-analysisadhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,and we framed our research question using the population,intervention,control and outcomes format.We conducted comprehensive electronic searches across various databases,employing a Boolean search strategy with predefined search terms.Only randomized controlled trials(RCTs)were included for quantitative analysis.Results Totally,10 RCTs met our inclusion criteria for quantitative analysis.The results indicated that urethrocutaneous fistula,glans dehiscence,and stricture rates were comparable between the two groups.The incidence of meatal stenosis was found to be significantly lower in the GTIP group with a relative risk(RR)of 0.32(95%confidence interval(Cl)0.15 to 0.67).Conclusion The coucomes UCF,glans dehiscence,and stricture rates were comparable between the two groups.Notably,the incidence of meatal stenosis was found to be significantly lower in the grafted TIP group.In terms of operative time,our quantitative synthesis demonstrated that the TIP group had a shorter operative time than the GTIP group with significant heterogeneity.

Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing, polydioxanone and polyglactin sutures

Background Polyglactin(PG)and polydioxanone(PDS)sutures are extensively used based on the surgeon's preference.The development of post-reconstruction urethrocutaneous fistula(UCF)is variably attributed to the choice of suture material for urethroplasty.This meta-an alysiscompares complications of hypospadia srepair using PGand PDS sutures.Methods The systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.The authors conducted thorough searches in databases including MEDLINE,EMBASE,CENTRAL,Scopus,Google Scholar,and clinical trial registries.Outcome measures included UCF,meatal stenosis,wound infection,urethral stricture,glans dehiscence,and overall complications.Quantitative analysis was used with fixed or random-effect models to find the pooled risk ratio and I2 heterogeneity.Results The criteria for inclusion were met by five comparative studies with the inclusion of 1244 children altogether.Pooled analysis failed to show a statistically significant difference in the incidence of meatal stenosis,urethral stricture,wound infection,and total complications using PG and PDS sutures.However,it showed a reduction in the incidence of UCF with PDS suture hypospadias repairs(risk ratio=0.66,95%Cl 0.48 to 0.92).Conclusions PDS sutures are associated with decreased incidence of UCF than PG after hypospadias repair.The incidence of meatal stenosis,urethral stricture,wound infection,and total complications was not affected by the type of suture material used for repair.Clinical implications This meta-analysis suggests decreased incidence of UCF when PDS sutures are used for hypospadias repair which may impact the choice of suturematerialforrepair.