Does Block Anesthesia Used in Hypospadias Surgery Increase Complication Rates?

Objective: Caudal and penile block are two commonly used methods for providing analgesia during and after hypospadias surgery. Although caudal block is a more popular method than penile block, it is thought to contribute to venous congestion and thus to poor healing and fistula formation at the suture line. In our study, we compared postoperative complication rates in patients operated for distal hypospadias with penile or caudal block. Methods: The records of 44 patients who underwent distal hypospadias surgery at pediatric surgery clinic of Okmeydani Trainig and Research Hospital between 2013 and 2018 were retrospectively reviewed. Patients were divided into two groups as caudal block and penile block groups. Patients were evaluated for meatal stenosis and urethral fistula development. Results: There were 26 patients in the penile block gruop and 18 patients in caudal block grop. Mean age was 2.3 in the penile block group and 3.5 in the caudal block group. In penile block grop, fistula was observed in 2 patients (7.6%) and meatal stenosis in 4 patients (15.3%). In caudal block group fistula was observed in 1 patient (5.5%) and meatal stenosis was observed in 2 patients (11.1%). There was no statistically significant difference between the two groups. Conclusion: Both penile and caudal block are commonly used in hypospadias surgery for providing analgesia. In the literature, there are studies showing that the caudal block contributes to urethral fistula formation. In our study, there was no significant difference in the complication rates between the two groups.