Oostland, Suzanne (2024) THE EFFECTS OF CATHETER DIAMETER ON POSTOPERATIVE OUTCOMES IN HYPOSPADIAS SURGERY Pediatric urology. thesis, Medicine.
Full text available on request.Abstract
Objective: To examine the impact of the intraoperative catheter diameter on postoperative outcomes in pediatric patients undergoing distal hypospadias surgery: to evaluate complication rates and functional outcomes (Qmax) when using different catheter sizes. Patients and Methods: This study is part of the prospective, multicenter Dutch Hypospadias Study, which included 744 pediatric patients who underwent hypospadias surgery. Patients were stratified based on the catheter size used during urethroplasty: smaller catheters (Ch 6 and Ch 8) versus larger catheters (Ch 10 and Ch 12). The outcome was measured by postoperative complications, Qmax values, and the need for reoperation at the age of 5 years. Results: The use of larger catheters (Ch 10 and Ch 12) was associated with higher complication rates, including increased incidences of dehiscence (15.2% vs. 7.0%) and the necessity for subsequent reoperations (20.1% vs. 8.6%) compared to smaller catheters. Despite higher Qmax values being observed in the larger catheter group (mean Qmax 13.2 mL/s vs. 11.22 mL/s for the smaller catheter group; P<0.001). When using the Tzu Chi nomogram the larger catheters again showed a better Qmax compared to the smaller catheters (p=0.017). Conclusion: The choice of catheter size in hypospadias surgery significantly affects postoperative outcomes. While larger catheters may improve Qmax, they also increase the risk of complications and the likelihood of needing operative re-interventions. These findings highlight the need for careful preoperative planning and consideration of catheter size to optimize surgical outcomes and minimize adverse events. Further research, especially the clinical implications of a lower Qmax, is necessary to validate these findings before adjusting surgical guidelines.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Faculty: | Medical Sciences |
| Date Deposited: | 12 Nov 2024 12:21 |
| Last Modified: | 12 Nov 2024 12:21 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3779 |
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