Treatment experience and related factors of urethral diverticulum after primary repair of hypospadias in children

Objective To summarize the related factors of urethral diverticulum formation after primary repair of hypospadias in children and to explore the appropriate treatments of urethral diverticulum. Methods The clinical data of urethral diverticulum after hypospadias operation were retrospectively analyzed from December 2012 to March 2019 .The clinical characteristics of diverticulum were summarized.Age, hypospadias grade, surgical approaches, diameter of glans, length of neourethra, secondary coverage and urethral stricture history, potential factors with postoperative urethral diverticulum, were analyzed by logistic regression analysis.P<0.05 was used as a statistical criterion. Results Postoperative urethral diverticulum was found in 17 hypospadias children.Urethral diverticulum disappeared in 4 cases after indwelling urethral catheter.Among them, surgery was performed once (n=5) and multiple times (n=3). Five cases had no dysuria or abnormal urinary tract with no surgery.Statistical analysis showed that the grade of hypospadias, the method of surgical repairment (Duckett’s procedure), the length of neourethra and the history of urethral dilatation were all related factors for urethral diverticulum after hypospadias surgery. Conclusions Grade of hypospadias, approach of surgical repair (Duckett’s procedure), length of neourethra and history of urethral stricture are all related factors affecting urethral diverticulum after hypospadias surgery in children.Urethral diverticulum without symptoms may be observed conservatively in children.Early urethral dilation is prescribed for urethral diverticulum.And diverticulum without distal urethral stricture may be treated simply by urethral diverticuloplasty; diverticulum with distal urethral stricture requires removing stricture and then urethroplasty. Key words: Hypospadias; Urethral diverticula; Postoperative complications