{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:28:29Z","timestamp":1786969709788,"version":"build-2736575974"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"DOI":"10.1007\/s00345-026-06688-4","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:06:53Z","timestamp":1786968413000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pain and safety outcomes of different anesthetic techniques in hypospadias surgery: a network meta-analysis of randomized clinical trials"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3604-8289","authenticated-orcid":false,"given":"Nadhif Faza","family":"Ananda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukhlis Akmal","family":"Taher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Tjandra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Antonio","family":"Boentoro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen Graciana","family":"Setiawan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armand","family":"Achmadsyah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arry","family":"Rodjani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard Reinaldi","family":"Situmorang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Putu Angga Risky","family":"Raharja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irfan","family":"Wahyudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"6688_CR1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.27544","author":"SA Halaseh","year":"2022","unstructured":"Halaseh SA, Halaseh S, Ashour M, Ashour ME (2022) Hypospadias: a comprehensive review including its embryology, etiology and surgical techniques. Cureus. https:\/\/doi.org\/10.7759\/cureus.27544","journal-title":"Cureus"},{"issue":"6","key":"6688_CR2","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1016\/j.jpurol.2023.08.010","volume":"19","author":"X Shan","year":"2023","unstructured":"Shan X, Aguilar S, Canon S (2023) Hypospadias prevalence by severity and associated risk factors: a population-based active surveillance analysis. J Pediatr Urol 19(6):720\u2013e1. https:\/\/doi.org\/10.1016\/j.jpurol.2023.08.010","journal-title":"J Pediatr Urol"},{"key":"6688_CR3","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S516249","author":"J Xu","year":"2025","unstructured":"Xu J, Liu X, Zhao J, Zhao J, Li H, Ye H, Ai S (2025) Comprehensive review on personalized pain assessment and multimodal interventions for postoperative recovery optimization. J Pain Res. https:\/\/doi.org\/10.2147\/JPR.S516249","journal-title":"J Pain Res"},{"issue":"9","key":"6688_CR4","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/j.bjae.2020.04.006","volume":"20","author":"B Cusack","year":"2020","unstructured":"Cusack B, Buggy DJ (2020) Anaesthesia, analgesia, and the surgical stress response. BJA Educ 20(9):321\u20138. https:\/\/doi.org\/10.1016\/j.bjae.2020.04.006","journal-title":"BJA Educ"},{"key":"6688_CR5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2025.111792","volume":"103","author":"H Nakamura","year":"2025","unstructured":"Nakamura H, Shimada K, Iwagami M, Masue T, Tamiya N, Inokuchi R (2025) Comparison of regional anesthesia techniques for hypospadias surgery: a systematic review. J Clin Anesth 103:111792. https:\/\/doi.org\/10.1016\/j.jclinane.2025.111792","journal-title":"J Clin Anesth"},{"issue":"5","key":"6688_CR6","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.1097\/JU.000000000000144","volume":"205","author":"AC Adler","year":"2021","unstructured":"Adler AC, Chandrakantan A, Lee AD, Koh CJ, Janzen NK, Austin PF (2021) Effect of caudal vs. penile block on the incidence of hypospadias complications following primary repairs: a retrospective cohort study. J Urol 205(5):1454\u20131459. https:\/\/doi.org\/10.1097\/JU.000000000000144","journal-title":"J Urol"},{"issue":"12","key":"6688_CR7","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1136\/rapm-2022-103680","volume":"47","author":"DK Choudhry","year":"2022","unstructured":"Choudhry DK, Heredia L, Brenn BR, Brown M, Carvalho NF, Whaley MC, Shaik SS, Hagerty JA, Bani Hani A (2022) Nerve stimulation guided bilateral pudendal nerve block versus landmark-based caudal block for hypospadias repair in young children: a prospective, randomized, pragmatic trial. Reg Anesth Pain Med 47(12):744\u20138. https:\/\/doi.org\/10.1136\/rapm-2022-103680","journal-title":"Reg Anesth Pain Med"},{"key":"6688_CR8","doi-asserted-by":"publisher","DOI":"10.48047\/NQ.2022.20.6.NQ23016","author":"HA Khalil","year":"2022","unstructured":"Khalil HA, Ibrahiem NM, Elsaid NM, Ibrahim DM (2022) Caudal Block Versus Penile Block for Postoperative Pain Relief in Pediatric Patients Undergoing Hypospadias Repair. NeuroQuantolog. https:\/\/doi.org\/10.48047\/NQ.2022.20.6.NQ23016","journal-title":"NeuroQuantolog"},{"key":"6688_CR9","doi-asserted-by":"publisher","DOI":"10.1186\/s42077-021-00172-4","author":"WA Ahmed","year":"2021","unstructured":"Ahmed WA, Shokier MH, Kasem AA, El Aziz MH, Saed SG (2021) Comparative study between ultrasound-guided pudendal nerve block and caudal epidural block anesthesia in children undergoing hypospadias surgery. Ain-Shams J Anesthesiol. https:\/\/doi.org\/10.1186\/s42077-021-00172-4","journal-title":"Ain-Shams J Anesthesiol"},{"issue":"5","key":"6688_CR10","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1097\/AAP.0000000000000447","volume":"41","author":"P Kendigelen","year":"2016","unstructured":"Kendigelen P, Tutuncu AC, Emre S, Altindas F, Kaya G (2016) Pudendal versus caudal block in children undergoing hypospadias surgery: a randomized controlled trial. Reg Anesth Pain Med 41(5):610\u2013615. https:\/\/doi.org\/10.1097\/AAP.0000000000000447","journal-title":"Reg Anesth Pain Med"},{"issue":"1","key":"6688_CR11","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.jpurol.2021.11.006","volume":"18","author":"A Koul","year":"2022","unstructured":"Koul A, Shukla D, Aggrawal SK, Sethi N (2022) Incidence of urethrocutaneous fistula following distal hypospadias repair with and without caudal epidural block: A randomized pilot study. J Pediatr Urol 18(1):58\u2013e1. https:\/\/doi.org\/10.1016\/j.jpurol.2021.11.006","journal-title":"J Pediatr Urol"},{"issue":"1","key":"6688_CR12","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.jpurol.2021.11.009","volume":"18","author":"F Alizadeh","year":"2022","unstructured":"Alizadeh F, Amraei M, Haghdani S, Honarmand A (2022) The effect of caudal epidural block on the surgical complications of hypospadias repair in children aged 6 to 35 months: a randomized controlled trial. J Pediatr Urol 18(1):59\u2013e1. https:\/\/doi.org\/10.1016\/j.jpurol.2021.11.009","journal-title":"J Pediatr Urol"},{"key":"6688_CR13","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.ijso.2020.12.013","volume":"29","author":"T Karami","year":"2021","unstructured":"Karami T, Hoshyar H, Tavana AM (2021) Comparing caudal block and penile block using rectal acetaminophen in postoperative analgesia of hypospadias repair: a randomized clinical trial study. Int J Surg Open 29:9\u201313. https:\/\/doi.org\/10.1016\/j.ijso.2020.12.013","journal-title":"Int J Surg Open"},{"issue":"7","key":"6688_CR14","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1111\/j.1460-9592.2011.03702.x","volume":"22","author":"P Kundra","year":"2012","unstructured":"Kundra P, Yuvaraj K, Agrawal K, Krishnappa S, Kumar LT (2012) Surgical outcome in children undergoing hypospadias repair under caudal epidural vs penile block. Pediatr Anesth 22(7):707\u201312. https:\/\/doi.org\/10.1111\/j.1460-9592.2011.03702.x","journal-title":"Pediatr Anesth"},{"issue":"6","key":"6688_CR15","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1213\/ANE.0b013e3182a8ee52","volume":"117","author":"ZM Naja","year":"2013","unstructured":"Naja ZM, Ziade FM, Kamel R, El-Kayali S, Daoud N, El-Rajab MA (2013) The effectiveness of pudendal nerve block versus caudal block anesthesia for hypospadias in children. Anesth Analgesia 117(6):1401\u20131407. https:\/\/doi.org\/10.1213\/ANE.0b013e3182a8ee52","journal-title":"Anesth Analgesia"},{"key":"6688_CR16","doi-asserted-by":"publisher","first-page":"151576","DOI":"10.1016\/j.sempedsurg.2025.151576","volume":"19","author":"F Sal\u0131k","year":"2025","unstructured":"Sal\u0131k F, Erbatur ME, Turgut MA, Sava\u015f Z, Kaydu A, Okur MH, Aydogdu H, Azizoglu M (2025) Effects of Caudal versus Penile Block on the Incidence of Hypospadias Complications Following Primary Repairs: A Prospective, Double-Blind, Randomized Controlled Trial. InSeminars Pediatr Surg 19:151576. https:\/\/doi.org\/10.1016\/j.sempedsurg.2025.151576","journal-title":"InSeminars Pediatr Surg"},{"key":"6688_CR17","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.82351","author":"S Kumari","year":"2025","unstructured":"Kumari S, Kumar M, Sinha M, Singha SK, Gupta H, Dubey R, Kumari SS (2025) A comparison of the ultrasound-guided dorsal penile block and ultrasound-guided caudal epidural block for postoperative analgesia in children undergoing hypospadias surgery: a randomized controlled study. Cureus. https:\/\/doi.org\/10.7759\/cureus.82351","journal-title":"Cureus"},{"issue":"3","key":"6688_CR18","doi-asserted-by":"publisher","first-page":"114","DOI":"10.4274\/TJAR.2025.241773","volume":"53","author":"H Sridharan","year":"2025","unstructured":"Sridharan H, Kesarkar N, Dias R (2025) Optimizing Paediatric Hypospadias Surgical Repair: Pudendal Nerve Block Versus Caudal Block for Superior Analgesia. Turkish J Anaesthesiol Reanimation 53(3):114. https:\/\/doi.org\/10.4274\/TJAR.2025.241773","journal-title":"Turkish J Anaesthesiol Reanimation"},{"key":"6688_CR19","doi-asserted-by":"publisher","unstructured":"Feng L, Zheng J, Zheng X, Ma Y, Fu H. The impact on postoperative complications and analgesia of different nerve block techniques after hypospadias repair: a network meta-analysis. Research Square [Preprint]. 2023. https:\/\/doi.org\/10.21203\/rs.3.rs-3530550\/v1","DOI":"10.21203\/rs.3.rs-3530550\/v1"},{"issue":"7","key":"6688_CR20","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1111\/pan.13657","volume":"29","author":"WM Splinter","year":"2019","unstructured":"Splinter WM, Kim J, Kim AM, Harrison MA (2019) Effect of anesthesia for hypospadias repair on perioperative complications. Pediatr Anesth 29(7):760\u2013767. https:\/\/doi.org\/10.1111\/pan.13657","journal-title":"Pediatr Anesth"}],"container-title":["World Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-026-06688-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00345-026-06688-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-026-06688-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:06:54Z","timestamp":1786968414000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00345-026-06688-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6688"],"URL":"https:\/\/doi.org\/10.1007\/s00345-026-06688-4","relation":{},"ISSN":["1433-8726"],"issn-type":[{"value":"1433-8726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"assertion":[{"value":"8 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.The authors declare no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This systematic review and network meta-analysis was conducted and reported in accordance with the PRISMA guidelines. The study protocol was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD420251163264.","order":2,"name":"Ethics","label":"Registration and reporting guidelines","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"580"}}