ArticleWorld journal of urology2026
Anatomic factors associated with postoperative events and reintervention after secondary urethroplasty in children with urethral strictures after hypospadias repair.
Article in World journal of urology, 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
purposeTo describe long-term outcomes of secondary urethroplasty for post-hypospadias urethral stricture in children and identify anatomic factors associated with a broad composite postoperative event endpoint.
methodsWe retrospectively reviewed 104 boys ≤ 12 years treated at a tertiary paediatric urology centre between 2010 and 2021. The primary outcome was a broad composite postoperative event endpoint comprising postoperative complications or additional urethral intervention for suspected impaired patency. Cox regression assessed associated factors. Receiver operating characteristic (ROC) analysis identified a cohort-derived threshold for radiographic stricture length (LUS), and Kaplan-Meier analysis assessed composite-event-free survival.
resultsMedian follow-up was 5.5 years. Overall, 63/104 boys (60.6%) met the composite endpoint, whereas 35/104 (33.7%) underwent unplanned reoperation. Prostatic utricle (aHR 1.78, 95% CI 1.01-3.14), longer LUS (aHR 1.14 per 1-cm increase, 95% CI 1.00-1.30), and baseline residual/recurrent ventral curvature (aHR 1.89, 95% CI 1.01-3.53) were independently associated with the composite endpoint. A cohort-derived LUS threshold of 1.8 cm yielded an AUC of 0.714 (95% CI 0.614-0.813), 77.8% sensitivity, 58.5% specificity, 74.2% positive predictive value, and 63.2% negative predictive value. Children with LUS ≥ 1.8 cm had lower composite-event-free survival.
conclusionIn this single-centre salvage cohort, postoperative morbidity and treatment burden after secondary urethroplasty for post-hypospadias urethral stricture were substantial. Longer LUS, prostatic utricle, and baseline residual/recurrent ventral curvature were anatomic factors associated with the composite endpoint. The cohort-derived 1.8-cm threshold may provide a practical marker for risk stratification, family counselling, and postoperative surveillance, but requires independent paediatric validation.
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