Background Polyglactin (PG) and polydioxanone (PDS) sutures are extensively used based on the surgeon’s preference. The development of post-reconstruction urethrocutaneous fistula (UCF) is variably attributed to the choice of suture material for urethroplasty. This meta-analysis compares complications of hypospadias repair using PG and PDS sutures. Methods The systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors conducted thorough searches in databases including MEDLINE, EMBASE, CENTRAL, Scopus, Google Scholar, and clinical trial registries. Outcome measures included UCF, meatal stenosis, wound infection, urethral stricture, glans dehiscence, and overall complications. Quantitative analysis was used with fixed or random-effect models to find the pooled risk ratio and I2 heterogeneity. Results The criteria for inclusion were met by five comparative studies with the inclusion of 1244 children altogether. Pooled analysis failed to show a statistically significant difference in the incidence of meatal stenosis, urethral stricture, wound infection, and total complications using PG and PDS sutures. However, it showed a reduction in the incidence of UCF with PDS suture hypospadias repairs (risk ratio=0.66, 95% CI 0.48 to 0.92). Conclusions PDS sutures are associated with decreased incidence of UCF than PG after hypospadias repair. The incidence of meatal stenosis, urethral stricture, wound infection, and total complications was not affected by the type of suture material used for repair. Clinical implications This meta-analysis suggests decreased incidence of UCF when PDS sutures are used for hypospadias repair which may impact the choice of suture material for repair. PROSPERO registration number CRD42023409710. All data relevant to the study are included in the article or uploaded as supplemental information.

中文翻译：

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尿道下裂修复中的尿道成形术后并发症：比较聚二氧环己酮和聚乳酸缝合线的系统回顾和荟萃分析

背景 聚乳糖素 (PG) 和聚二氧环己酮 (PDS) 缝合线根据外科医生的偏好被广泛使用。重建后尿道皮肤瘘（UCF）的发生与尿道成形术缝合材料的选择有不同的影响。该荟萃分析比较了使用 PG 和 PDS 缝合线修复尿道下裂的并发症。方法 根据系统评价和荟萃分析指南的首选报告项目进行系统评价和荟萃分析。作者在 MEDLINE、EMBASE、CENTRAL、Scopus、Google Scholar 和临床试验注册数据库等数据库中进行了彻底的搜索。结果指标包括 UCF、尿道狭窄、伤口感染、尿道狭窄、龟头裂开和总体并发症。使用固定或随机效应模型进行定量分析，以找出合并风险比和 I2 异质性。结果 5 项比较研究共纳入 1244 名儿童，符合纳入标准。汇总分析未能显示使用 PG 和 PDS 缝合线的尿道狭窄、尿道狭窄、伤口感染和总并发症发生率存在统计学显着差异。然而，PDS 缝合尿道下裂修复术显示 UCF 的发生率降低（风险比 = 0.66，95% CI 0.48 至 0.92）。结论 尿道下裂修复术后，PDS 缝合比 PG 缝合能降低 UCF 发生率。尿道口狭窄、尿道狭窄、伤口感染和总并发症的发生率不受修复所用缝合材料类型的影响。临床意义 这项荟萃分析表明，当 PDS 缝合线用于尿道下裂修复时，UCF 的发生率会降低，这可能会影响修复缝合材料的选择。PROSPERO 注册号 CRD42023409710。与研究相关的所有数据都包含在文章中或作为补充信息上传。