Human umbilical cord allograft associated with higher pediatric urethrocutaneous fistula repair success rates.
J Pediatr Urol
; 20(4): 692.e1-692.e6, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-38951046
ABSTRACT
BACKGROUND:
Urethrocutaneous fistula (UCF) formation is a known complication following hypospadias repair, affecting between 5 and 70% of cases. Moreover, approximately 30% of patients experience refistulization after UCF repair. The use of extracellular matrices, such as AmnioCord, a dehydrated human umbilical cord allograft manufactured by MiMedx®, may mitigate high rates of refistulization.OBJECTIVE:
To determine whether the use of AmnioCord during UCF repair is associated with reduced incidence of subsequent UCFs among pediatric patients. DESIGN, SETTING, ANDPARTICIPANTS:
Electronic medical records were retrospectively reviewed among 60 patients who underwent at least one UCF repair at a pediatric hospital in a large urban setting in the U.S. between January 2012-June 2018. Patients were followed through January 2024. OUTCOME MEASUREMENTS AND STATISTICALANALYSIS:
Adjusted generalized estimating equation regression models were used to assess the association between AmnioCord use and rates of refistulization, while controlling for confounding variables.RESULTS:
The number of fistula presentations per patient ranged from one to four; 53.3% had one fistula, 30.0% had two, and 16.6% had three or more. Overall fistula repair success rate was 56.8% but significantly differed by AmnioCord use in adjusted modelling; 69.4% of cases that received AmnioCord were successfully repaired, compared to 47.2% of cases that did not receive AmnioCord. In adjusted models, patients who received AmnioCord had 2.66 times greater odds of surgical success than patients who did not receive AmnioCord (95% CI1.13-6.24; p = 0.02).CONCLUSIONS:
This study demonstrates a positive association between AmnioCord use and successful UCF closure among pediatric patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
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Umbilical Cord
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Urethral Diseases
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Urinary Fistula
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Cutaneous Fistula
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Hypospadias
Limits:
Child
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Child, preschool
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Humans
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Infant
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Male
Language:
En
Journal:
J Pediatr Urol
Year:
2024
Type:
Article