SynthesisWorld journal of urology2026
Non-operative management of early onset small urethrocutaneous fistula post hypospadias repair: a systematic review.
Synthesis in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Treatment effect or natural healing? Interpreting non-operative management of early urethrocutaneous fistulas after hypospadias repair.World journal of urology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUrethrocutaneous fistulas (UCF) after hypospadias repair are typically managed surgically, but conservative approaches may offer a less invasive, cost-effective alternative. While surgical repair remains the standard, non-operative strategies may eliminate anesthesia exposure, shorten recovery time, and lower healthcare costs. However, systematic evidence regarding these approaches remains limited.
methodsThis narrative systematic review evaluates non-operative management for small (typically ≤ 2 mm) UCFs. A comprehensive search was conducted across PubMed, Cochrane, ScienceDirect, Wiley, and Google Scholar up to April 2025. The study followed PRISMA guidelines and is registered in PROSPERO (CRD420251069870). We included randomized controlled trials (RCTs), comparative trials, case series, and anecdotal reports involving children (< 18 years). Risk of bias was assessed using Cochrane RoB-2, ROBINS-I, and JBI Critical Appraisal tools.
resultsFive studies involving 73 patients were included for analysis. Due to significant clinical heterogeneity in fistula characteristics and interventions, a pooled closure rate was not calculated. Reported individual study closure rates ranged from 53.8% to 62.5% in the primary series, with one anecdotal report (n = 1) showing 100% success. Success was more frequently observed in early-onset UCFs (diagnosed within 14 days post-catheter removal) and those with a diameter ≤ 2 mm. Minor adverse events included localized heat (42.8%) and transient dysuria (4.7%). Cost-analysis from one RCT indicated that non-operative adhesive application cost approximately 9.3% compared to total operative costs. Most included studies were classified as having a high risk of bias.
conclusionNon-operative approaches using tissue adhesives, fibrin glue, or recatheterization may be viable for small (≤ 2 mm), early-onset UCFs. However, the current evidence is limited, heterogeneous, and carries a high risk of bias. These findings should be considered hypothesis-generating, and further high-quality comparative studies are required to establish definitive clinical protocols.
trial registrationPROSPERO CRD420251069870.
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