{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T21:10:08Z","timestamp":1787605808366,"version":"build-2736575974"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Surgery for hypospadias is usually performed under general anesthesia, with anesthesiologists employing caudal, epidural, and penile blocks to provide postoperative analgesia. Recent research suggests a possible association between increased incidence of complications (especially urethrocutaneous fistulae [UCFs]) and perioperative use of caudal blocks. The increased incidence of complications was attributed to the vasodilatation and penile engorgement following the regional block. The purpose of this study is to determine the overall incidence of complications following urethroplasty in our institute and determine if there is a causal association with neuraxial block.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Electronic medical records of all children who underwent primary urethroplasty for distal hypospadias in our institutre from 2011 to 2020 were reviewed and statistical analysis done.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 333 children with a mean age of 4.6 years were included in the study. Caudal block was given for 229 children and single-dose epidural for 32 children. Seventy-two children did not receive any regional block. The incidence of glanular dehiscence was 6% and UCF was 19% in neuraxial blocks compared to 3% and 15% in the other group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.2 and 0.4). Multivariate regression analysis of level of hypospadias, severity of chordee, surgeon\u2019s experience, and type of local anesthetic or additive used showed no other significant independent variable affecting the outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Postoperative urethral fistula formation was observed in children who received and did not receive neuraxial analgesia for urethroplasty surgery, with the incidence being marginally higher in the neuraxial block group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_40_25","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T03:00:10Z","timestamp":1751338810000},"page":"630-633","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Regional Analgesia on Postoperative Complications in Children Undergoing Urethroplasty for Distal Hypospadias Repair \u2013 A Retrospective Cohort Study"],"prefix":"10.4103","volume":"30","author":[{"given":"Arun Kumar","family":"Loganathan","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Ashok","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sampriti","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Jehangir","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita Shirley","family":"Joselyn","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"R1-20250901","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.ucl.2010.03.010","article-title":"Hypospadias:Etiology and current research","volume":"37","author":"Kalfa","year":"2010","journal-title":"Urol Clin North Am"},{"key":"R2-20250901","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.urology.2013.08.041","article-title":"Pain management practice patterns for common pediatric urology procedures","volume":"83","author":"Morrison","year":"2014","journal-title":"Urology"},{"key":"R3-20250901","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1093\/bja\/aeg064","article-title":"Caudal additives in children \u2013Solutions or problems?","volume":"90","author":"de Beer","year":"2003","journal-title":"Br J Anaesth"},{"key":"R4-20250901","doi-asserted-by":"crossref","first-page":"222","DOI":"10.4103\/iju.IJU_252_18","article-title":"Does caudal analgesia increase the rates of urethrocutaneous fistula formation after hypospadias repair?Systematic review and meta-analysis","volume":"35","author":"Goel","year":"2019","journal-title":"Indian J Urol"},{"key":"R5-20250901","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1111\/j.1460-9592.2011.03702.x","article-title":"Surgical outcome in children undergoing hypospadias repair under caudal epidural versus penile block","volume":"22","author":"Kundra","year":"2012","journal-title":"Paediatr Anaesth"},{"key":"R6-20250901","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.jpurol.2013.11.011","article-title":"Duration of follow-up to diagnose hypospadias urethroplasty complications","volume":"10","author":"Snodgrass","year":"2014","journal-title":"J Pediatr Urol"},{"key":"R7-20250901","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.jpurol.2023.10.039","article-title":"Urethrocutaneous fistula and glans dehiscence formation of hypospadias surgery in patients receiving caudal block versus non-caudal block:A meta-analysis","volume":"20","author":"Xia","year":"2024","journal-title":"J Pediatr Urol"},{"key":"R8-20250901","doi-asserted-by":"crossref","first-page":"45.e1","DOI":"10.1016\/j.jpurol.2016.09.011","article-title":"Can regional anesthesia have an effect on surgical outcomes in patients undergoing distal hypospadia surgery?","volume":"13","author":"Saavedra-Belaunde","year":"2017","journal-title":"J Pediatr Urol"},{"key":"R9-20250901","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1111\/anae.13463","article-title":"Impact of caudal block on postoperative complications in children undergoing tubularised incised plate urethroplasty for hypospadias repair:A retrospective cohort study","volume":"71","author":"Kim","year":"2016","journal-title":"Anaesthesia"}],"container-title":["Journal of Indian Association of Pediatric Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_40_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:37:14Z","timestamp":1787067434000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_40_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,30]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jiaps.jiaps_40_25","relation":{},"ISSN":["0971-9261","1998-3891"],"issn-type":[{"value":"0971-9261","type":"print"},{"value":"1998-3891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,30]]},"assertion":[{"value":"2025-02-05","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}