Urethrocutaneous fistula (UCF) is a common complication following hypospadias repair. Many articles reported multifactorial risks related to UCF. In our institutions, there were many different hypospadias repair techniques among the pediatric surgeon team. The aim of this study was to identify the predictive risk factors of UCF after hypospadias repair in children.

A retrospective chart review was performed for all hypospadias patients (0-18 years old) who underwent first surgical repair in our institution (January 2006 - August 2023) and had at least 6-months of follow-up time. Data collected included demographics, pre and peri-operative risk factors, complications and managements. Logistic regression analysis was used with IBM SPSS statistics 21 for univariate and multivariate analysis.

There were 319 hypospadias with 205 proximal opening (64.3%), 84 penile opening (26.3%), and 30 distal opening (9.4%). DSD was diagnosed in 140 children (43.9%). Median age for urethroplasty was 21.5 months old. Mean penile length was 3.51 cm. UCF developed in 188 patients (58.9%). The mean time of UCF occurrence was 30 days after hypospadias repair. Significant risk factors for UCF creation are demonstrated in attached table. Two-stage urethroplasty, using of feeding tube as a stent, and larger stent are significant predictive factors by multivariate analyzed. The UCF was successfully repaired with median 1 operation.

Urethroplasty technique, urethral stent type, and size are significant risk factor for UCF. Appropriate selection of surgical technique and stent may reduce the incidence of UCF.