Objective To explore the influencing factors of postoperative urethral complications in children with hypospadias,and to construct a risk assessment model based on the results of regression analysis,followed by testing of its effectiveness.Methods A total of 200 children with hypospadias who underwent surgery in the hospital from April 2020 to August 2022 as the study subjects.General Information Questionnaire was used to investigate the basic information of the children.The influencing factors of postoperative urethral complications in children with hypospadias were screened through univariate analysis and multivariate Logistic regression analysis.Based on this,a risk assessment model for postoperative urethral complications in children with hypospadias was constructed and its assessment effectiveness was tested.Results The 42 children who developed postoperative urethral complications were in the occurrence group,while the remaining 158 were in the non-occurrence group.Univariate analysis and multivariate Logistic regression analysis showed that the factors influencing the occurrence of postoperative urethral complications in children with hypospadias include the age,degree of penile curvature,urethral defect length,incision infection,postoperative skin necrosis,incision healing,and degree of postoperative catheter patency(P＜0.05).Specifically,the risk of urethral complications increased in patients with age＞3 years,with moderate to severe penile curvature,urethral defect length ≥4 cm,incision infection,postoperative skin necrosis,poor incision healing,and poor drainage.The Hosmer-Lemeshow test for the risk assessment model of postoperative urethral complications in children with hypospadias showed that the difference was not statistically significant(x2=0.318,P=0.573),indicating good fit.The area under the receiver operating characteristic(ROC)curve was 0.915(95％CI:0.869～0.950),with a maximum Youden index of 0.645.The clinical application results showed that using P ≥ 0.536 as the criterion for predicting postoperative urethral complications,the sensitivity and specificity of the model prediction reached over 90％,indicating very high reliability of the predictions.Moreover,with Kappa＞0.75,the consistency between the predicted and actual outcomes was remarkably high.Conclusion Factors influencing the occurrence of postoperative urethral complications in children with hypospadias include the age,degree of penile curvature,urethral defect length,incision infection,postoperative skin necrosis,incision healing,and degree of postoperative catheter patency.The risk assessment model for postoperative urethral complications in children with hypospadias,constructed based on the regression equation,has a high reliability and consistency in predicting outcomes.
Children with hypospadiasUrethral complicationsInfluencing factorsRisk assessment modelEffect verification
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