WOFAPS 2025 8th World Congress of Pediatric Surgery

Mehret Enaro, Ken Muma

AIC KIJABE HOSPITAL

Introduction:

Hypospadias is the second most common congenital urologic anomaly in newborn boys. Corrective surgery is associated with a high complication rate ranging from 5-30% in Western literature and up to 60% reported in Sub-Saharan Africa. Standardization of care has been shown to improve outcomes in surgical care. This was also demonstrated in hypospadias care. To reduce complications in our setting, we developed and implemented a standardized protocol.

Methods:

A retrospective review was done comparing the pre- and post-intervention arms. The protocol entailed a standardized bundle that was composed of pre-operative, intraoperative, and post-operative interventions for hypospadias patients. In the pre-intervention phase, data were collected from 284 patients and 140 patients in the post-intervention phase. Data were analyzed using STATA 18 software.

Results:

89% (252/281) were phenotypically male, and 10% (29) had DSD (differences in sexual development). Mean age in years was 4.1±3.9 [0 – 23.9yrs] in n1 and 4.7 ± 4.55 [0 – 19.4 yrs], P=0.13, respectively. Overall complication rates were 51.4% for n1 and 25% for n 2 (p=0.001) value). Among the complications, Urethrocutaneous fistula (UCF) was the most common (27.3% vs. 10.2 %, p=0.001), followed by wound infection (23% vs. 4%; p=0.04). There was a cost reduction of 8684 KES [(CI:5335,12034 KES), p=0.001] in the post-intervention phase compared to the pre-intervention phase.

Conclusion:

The use of a standardized protocol in hypospadias care significantly reduces the post-operative complication rate and cost.