Effects of caudal versus penile block on the incidence of hypospadias complications following primary repairs: A prospective, double-blind, randomized controlled trial

IF 2.5 3区医学 Q3 PEDIATRICS

Seminars in Pediatric Surgery Pub Date : 2026-03-01 Epub Date: 2025-11-19 DOI:10.1016/j.sempedsurg.2025.151576

Fikret Salık , Meral Erdal Erbatur , Mehmet Ali Turgut , Zülfü Savaş , Ayhan Kaydu , Mehmet Hanifi Okur , Hakkari Aydogdu , Mustafa Azizoglu

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引用次数: 0

Abstract

Introduction

This prospective, randomized, double-blinded study aimed to compare the incidence of postoperative complications and perioperative analgesic efficacy between caudal and penile block in children undergoing primary hypospadias repair.

Methods

Sixty-two boys aged 6–48 months were randomly assigned to receive either caudal block group (CB, n = 31) or penile block group (PB, n = 31) for preemptive analgesia before surgery. All patients underwent tubularized incised plate urethroplasty. The primary outcome was the incidence of postoperative complications, including urethrocutaneous fistula and meatal stenosis, assessed at 3- and 6-months post-surgery. Secondary outcomes included total perioperative fentanyl consumption and the number of patients requiring rescue analgesia.

Results

There were no significant differences in the incidence of total complications (9.7 % vs. 16.1 %, p = 0.449), fistula (6.5 % vs. 3.2 %, p = 0.554), or meatal stenosis (3.2 % vs. 12.9 %, p = 0.162) between the CB and PB groups. However, fistula rate was significantly higher in patients with midpenil compared to distal hypospadias (13 % vs. 0 %, p = 0.021). Total perioperative fentanyl consumption and the number of patients requiring rescue analgesia were significantly lower in the CB group (p = 0.041 and p = 0.01, respectively).

Conclusion

In conclusion, caudal block provides superior perioperative analgesia without increasing the risk of postoperative complications compared to penile block in children undergoing primary hypospadias repair.

Level of evidence

Level I.

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尾侧阻滞与阴茎阻滞对尿道下裂初次修复后并发症发生率的影响：一项前瞻性、双盲、随机对照试验。

本前瞻性、随机、双盲研究旨在比较行原发性尿道下裂修复术的儿童行尾侧阻滞和阴茎阻滞的术后并发症发生率和围手术期镇痛疗效。方法：将62例6 ~ 48月龄男孩随机分为尾侧阻滞组（CB, n = 31）和阴茎阻滞组（PB, n = 31）进行术前先发制人镇痛。所有患者均行管状切开钢板尿道成形术。主要结果是术后并发症的发生率，包括尿道瘘和金属狭窄，在术后3个月和6个月进行评估。次要结局包括围手术期芬太尼总消耗量和需要急救镇痛的患者人数。结果：CB组与PB组总并发症发生率（9.7% vs. 16.1%, p = 0.449）、瘘管发生率（6.5% vs. 3.2%, p = 0.554）、狭窄发生率（3.2% vs. 12.9%, p = 0.162）差异均无统计学意义。然而，与远端尿道下裂相比，中阴茎组的瘘管发生率明显更高（13% vs. 0%, p = 0.021）。CB组围手术期芬太尼总用量和需要抢救性镇痛的患者数量显著低于对照组（p = 0.041和p = 0.01）。结论：与阴茎阻滞相比，尾侧阻滞在儿童原发性尿道下裂修复术中提供了更好的围术期镇痛，且不增加术后并发症的风险。证据等级：一级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in Pediatric Surgery PEDIATRICS-SURGERY

CiteScore

2.80

自引率

5.90%

发文量

审稿时长

>12 weeks

期刊介绍： Seminars in Pediatric Surgery provides current state-of-the-art reviews of subjects of interest to those charged with the surgical care of young patients. Each bimontly issue addresses a single topic with articles written by the experts in the field. Guest editors, all noted authorities, prepare each issue.