Association between Head Injury and Serum Sodium Levels
Tim Jumbi,1 Swaleh Shahbal,1 Robert Mugo,1 Francis Osawa,1 Peter Mwika,1 Joel Lessan2
1 University of Nairobi
2 Kenyatta National Hospital
Correspondence to: Dr Jumbi Tim, PO Box 1059–00618, Ruaraka, Nairobi; email:
Urethro-cutaneous fistula (UCF) is one of the most frequently seen complications of hypospadias surgery requiring re-operation; it occurs with an incidence of between 4% and 28%. Risk factors associated with the development of UCF can be classified as preoperative, intraoperative or postoperative. The aim of this study was to determine the association of peri-operative risk factors and the development of urethrocutaneous fistula after hypospadias repair. A retrospective review of patients who had undergone hypospadias repair at Kenyatta National Hospital between 2013 and 2017 was conducted. 114 patient records were retrieved. The incidence of UCF was 47%. Risk factors that were significantly associated with UCF are hypospadias type (p=0.028), lack of a protective intermediate layer (p=0.002), and presence of postoperative complications (p=0.001). Age at surgery, suture material, type of repair and use of catheter/stents were not significant factors. Multivariate analysis showed wound infection and meatal stenosis as the most significant factors associated with UCF development.
Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the PHACO group had good (6/6 – 6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1 -–2 weeks follow –- up (p = 0.003) and at 4 – 6 weeks follow - up (p = 0.002). Both techniques produced comparable best corrected visual acuity (BCVA) at 4 – 6 weeks follow - up (p = 0.084). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). Rates of intraoperative complications were within the World Health Organization’s (WHO) acceptable standard of less than 5% in both groups. The PHACO group had a higher number of postoperative complications compared to with the MSICS group (p < 0.001). Postoperative borderline and poor uncorrected visual acuity were associated with age, total astigmatic change, and number of postoperative complications.
Key words: Hypospadias, Urethro-cutaneous fistula, Risk factors, Wound infection, Meatal stenosis
Ann Afr Surg. 2019; 16(2):59–63
Conflicts of Interest: None
© 2019 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.