Do preoperative leukocyte and neutrophil levels have a predictive value on the complications of hypospadias repair in children?
https://doi.org/10.4081/aiua.2022.4.459
Accepted: September 24, 2022
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Objective: Surgeons observed that the outcomes after the same repair technique in the same type of hypospadias performed by the same surgeon may be different. There may be some indeterminate factors that influence the results such as subclinical inflammation. Our study evaluated the predictor values of inflammatory hematologic parameters on the complications after hypospadias repair.
Materials and methods: We retrospectively reviewed the data of patients who underwent hypospadias repair between January 2016 and January 2019 in our clinic. Age at surgery, hypospadias type, repair technique, complications were recorded. Patients who underwent Snodgrass repair by a single surgeon were included in the study while patients who underwent different techniques or procedures that were performed by other surgeons were excluded. The levels of white blood cell, neutrophil, lymphocyte, platelet and monocyte, the mean platelet volumes were recorded from blood test that were performed one day before surgery. Neutrophil-lymphocyte ratio (NLR), plateletlymphocyte ratio (PLR), and other parameters were analyzed to determine their relationship with complications after hypospadias surgery.
Results: WBC and neutrophil levels were statistically higher in patients with complications (p = 0.006 and 0.017 respectively). Other hematological parameters were not different between patients with or without complications. To predict the complications, the WBC cutoff was 9500/mm3, the neutrophil cutoff was 3000/mm3.
Conclusions: WBC and neutrophil values were statistically significant in predicting the complications after Snodgrass repair in patients with hypospadias. Our result determined no relation between complications and NLR, PLR.
Retik AB, Atala A. Complications of hypospadias repair. Urologic Clinics of North America. 2002;29(2):329-339.
Dursun A, Ozsoylu S, Akyildiz BN. Neutrophil-to-lymphocyte ratio and mean platelet volume can be useful markers to predict sepsis in children. Pakistan Journal of Medical Sciences. 2018;34(4):918-922.
Chapman D, Kinnaird A, Rourke K. Independent Predictors of Stricture Recurrence Following Urethroplasty for Isolated Bulbar Urethral Strictures. Journal of Urology. 2017;198(5):1107-1112.
Mundy AR, Andrich DE. Urethral strictures. BJU International. 2011;107(1):6-26.
Hampson LA, McAninch JW, Breyer BN. Male urethral strictures and their management. Nature Reviews Urology. 2014;11(1):43-50.
Sciarra A, Salciccia S, Albanesi L, et al. Use of cyclooxygenase-2 inhibitor for prevention of urethral strictures secondary to transurethral resection of the prostate. Urology. 2005;66(6):1218-1222.
Mazdak H, Meshki I, Ghassami F. Effect of Mitomycin C on Anterior Urethral Stricture Recurrence after Internal Urethrotomy. European Urology. 2007;51(4):1089-1092.
Tabassi KT, Yarmohamadi A, Mohammadi S. Triamcinolone injection following internal urethrotomy for treatment of urethral stricture. Urology Journal. 2011;8(2):132-136.
Zhang K, Qi E, Zhang Y, et al. Efficacy and safety of local steroids for urethra strictures: A systematic review and meta-analysis. Journal of Endourology. 2014;28(8):962-968.
Gül M, Altıntaş E, Kaynar M, et al. The predictive value of platelet to lymphocyte and neutrophil to lymphocyte ratio in determining urethral stricture after transurethral resection of prostate. Turkish Journal of Urology. 2017;43(3):325-329.
Urkmez A, Topaktas R, Ozsoy E, et al. Is neutrophil to lymphocyte ratio a predictive factor for recurrence of urethral stricture? Revista da Associacao Medica Brasileira. 2019;65(12):1448-1453.
Bai R, Gao L, Jiang L, et al. The Validity of Neutrophil/lymphocyte Ratio as A Predictive Factor for Systemic Inflammatory Response Syndrome after Flexible Ureteroscopy Lithotripsy. Urology Journal. 2022;19(1):17-21.
Faasse MA, Liu DB. Early vs. late-presenting urethroplasty complications after hypospadias repair: A retrospective analysis of patient follow-up. Journal of Pediatric Urology. 2017;13(4):354.e1-354.e5. d
Snodgrass W, Villanueva C, Bush NC. Duration of follow-up to diagnose hypospadias urethroplasty complications. Journal of Pediatric Urology. 2014;10(2):208-211.
Hadidi AT. History of hypospadias: Lost in translation. Journal of Pediatric Surgery. 2017;52(2):211-217.
Urkmez A, Topaktas R, Ozsoy E, et al. Is neutrophil to lymphocyte ratio a predictive factor for recurrence of urethral stricture? Revista da Associacao Medica Brasileira. 2019;65(12):1448-1453.
Carney KJ, House J, Tillett J. 38: Effects of Dviu and Colchicine Combination Therapy on Recurrent Anterior Urethral Strictures. Journal of Urology. 2007;177(4S):14-14.
Polat N, Yildiz A, Yuksel M, et al. Association of Neutrophil – Lymphocyte Ratio With the Presence and Severity of Rheumatic Mitral Valve Stenosis. 2014.
Alkhouri N, Morris-stiff G, Campbell C, et al. Neutrophil to lymphocyte ratio : a new marker for predicting steatohepatitis and fibrosis in patients with nonalcoholic fatty liver disease. Liver international. 2012;32(2):297-302.
Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, et al. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol. 2012;23(4):265-273.
Kim EY, Lee JW, Yoo HM, et al. The Platelet-to-Lymphocyte Ratio Versus Neutrophil-to- Lymphocyte Ratio : Which is Better as a Prognostic Factor in Gastric Cancer ? Ann Surg Oncol. 2015;22(January (13)):4363-4370.
Topaktaş R. Hematologic parameters and Neutrophil / Lymphocyte ratio in the prediction of urethroplasty success. International Brazilian journal of urology. 2019;45(2):369-375.
Holland AJA, Smith GHH. Effect of the depth and width of the urethral plate on tubularized incised plate urethroplasty. Journal of Urology. 2000;164(2):489-491.
Tugtepe H, Thomas DT, Calikli Z, et al. A new objective scoring system for the prediction of complications after hypospadias surgery. In: 29th Congress of ESPU Abstract Book. ; 2018:96.
Sarhan O, Saad M, Helmy T, et al. Effect of Suturing Technique and Urethral Plate Characteristics on Complication Rate Following Hypospadias Repair: A Prospective Randomized Study. Journal of Urology. 2009;182(2):682-686.
Bush NC, Snodgrass W. Pre-incision urethral plate width does not impact short-term Tubularized Incised Plate urethroplasty outcomes. Journal of Pediatric Urology. 2017;13(6):625.e1-625.e6.
Copyright (c) 2022 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
