ArticleFrontiers in pediatrics2026
Association between penile ischemia duration and complications after hypospadias repair in children.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Clinical evidence regarding the impact of intraoperative penile ischemia during pediatric hypospadias repair remains inconclusive. Although experimental studies suggest that ischemia-reperfusion injury may impair wound healing, clinical data on the relationship between ischemia duration and postoperative outcomes in children are limited. This study aimed to determine whether the duration of intraoperative penile ischemia is associated with postoperative complications-specifically urethral fistula formation and meatal stenosis-in patients undergoing primary hypospadias repair. Methods: We conducted a retrospective, single-center cohort study of pediatric patients who underwent primary hypospadias repair with intraoperative penile tourniquet application over a 12-year period. The primary outcome was the occurrence of postoperative complications, specifically meatal stenosis or urethral fistula, requiring revision surgery. Secondary analyses assessed tourniquet duration, patient demographics, and key perioperative variables to identify potential risk factors for adverse outcomes. Results: Ninety-four patients were included. Postoperative complications requiring redo surgery occurred in 17 patients (18%), comprising urethral fistula ( Conclusions: Intraoperative penile ischemia duration within the mid-range commonly applied in clinical practice was not associated with an increased risk of postoperative fistula or meatal stenosis following primary hypospadias repair. These findings support the safety of standard penile tourniquet use during routine surgical procedures. However, prospective studies with standardized documentation of ischemia duration are needed to establish evidence-based safety thresholds and to further clarify potential ischemia-reperfusion effects.
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