FAKTOR PROGNOSTIK TERJADINYA FISTULA URETROKUTAN PADA PASIEN HIPOSPADIA PASCA URETROPLASTI DI RSUP DR. SARDJITO, YOGYAKARTA

DANIEL AGUSTINUS SOEMIARTO, Dr. dr. Rochadi, SpB (K) BA

2015 | Tesis | SP ILMU BEDAH ANAK

Latar belakang Insidensi hipospadia sekitar 3 sampai 5 tiap 1000 kelahiran hidup. Fistula uretrokutan adalah komplikasi yang sering terjadi dengan insidensi 10% sampai 15%. Tujuan penelitian Untuk mencari dan menganalisa faktor prognostik yang mempengaruhi terjadinya fistula uretrokutan pada pasien pascauretroplasti di institusi kami. Metode Kami meneliti catatan medik dari 88 pasien yang menjalani uretroplasti dengan penelitian cohort retrospective untuk mengidentifikasi faktor prognostik untuk kejadian fistula uretrokutan dari Januari 2009 sampai Desember 2012. Faktorfaktor ini kemudian dianalisa dengan menggunakan chi square (analisis univariat). Hasil Variabel bebas meliputi: usia saat operasi, kadar hemoglobin, status gizi, kadar lekosit, kadar albumin pre dan postoperatif, tipe hipospadia, lama operasi, dan lama dirawat. Dari semua variabel tidak ada satupun yang berpengaruh terhadap kejadian fistula uretrokutan. Tipe penoscrotal adalah yang terbanyak terjadi komplikasi fistula uretrokutan postoperatif yaitu 9 pasien (10.3%), diikuti tipe coronal, 6 (6.9%), midshaft penile, 5 (5.7%), distal penile, 3 (3.4%) dan scrotal, 3 (3.4%). Kesimpulan Tidak ada satupun variabel yang berpengaruh terhadap kejadian fistula uretrokutan pascauretroplasti.

Background Hypospadias occurring in approximately 3 to 5 per 1000 live births. Urethrocutaneous fistula is the most common complication with an incidence of 10% to 15%. Objective To review and analyze the prognostic factors that influencing urethrocutaneous fistula in children post urethroplasty in our institution. Method We reviewed medical records of 88 patients that underwent urethroplasty procedure using a cohort retrospective study to identified prognostic factors for urethrocutaneous fistula from January 2009 to December 2012. These factors then analyzed using chi square (univariate analysis). Result The variables potentially affecting outcome were reviewed, including: age the operation has done, haemoglobin level, nutritional status, leucocyte level, preoperative and postoperative albumin, type of hypospadias, operation time duration, and length of hospitalization. None of this variables were the strong factors associated with the outcome of urethrocutaneous fistula. Interestingly, phenoscrotal type was the most abundant type which has a fistula postoperative 9 (10.3%), followed with coronal, 6 (6.9%), midshaft penile, 5 (5.7%), distal penile, 3 (3.4%) and scrotal, 3 (3.4%), respectively, and the length of hospitalization more than 16 days, duration of operation more than 141 minutes, have a RR 0,48 (95% CI 0.189-1.259), RR 0.900 (95% CI 0.351-2.305), respectively. Conclusion This is a preliminary study of urethrocutaneous fistula event posturethroplasty at the patients with hypospadias in our institution. Eventhough none of the variables have a strong significant effects of the complication, but this study is still promising and need to continue to look for other variables that might be suitable in our institution.

Kata Kunci : hipospadia, fistula uretrokutan