The Predictive Role of Preoperative Hematological Parameters in Urethrocutaneous fistula Development Following Primary Hypospadias Surgery Repair: A Prospective Study

Introduction: Hypospadias represents a congenital male genital anomaly characterized by abnormal urethral meatus positioning. Despite surgical advancements, postoperative complications such as urethrocutaneous fistula occur in 25% of cases. This study investigated the association between preoperative hematologic indices and postoperative fistula formation.Methods: This prospective cohort study was conducted at Nemazi Hospital (Shiraz, Iran) between December 2017 and March 2024. The study involved 356 pediatric boys undergoing primary hypospadias repair. Comprehensive preoperative hematological evaluation included red blood cells (RBC) count, hemoglobin concentration, mean corpuscular volume (MCV), hematocrit, platelets count, white blood cells (WBC) count, lymphocyte/neutrophil percentages, and platelet-to-lymphocyte ratio. Postoperative fistula diagnosis involved standardized clinical examinations and parental reports. Statistical analysis included descriptive statistics along with nonparametric comparisons using the Mann-Whitney U test. Normality of data distribution was assessed using both Kolmogorov-Smirnov and Shapiro-Wilk testing.Results: The study population demonstrated mean hematological values as follows: RBC=4.85±0.67 million/µL, hemoglobin=12.39±1.47 g/dL, hematocrit=37±3.6%, platelets=333.4±93.8×10³/µL, and WBC=10.1±4.3×10³/µL. T Comparative analysis revealed no statistically significant differences in any hematological parameter between fistula and non-fistula groups (P=0.85). The dataset exhibited a normal distribution (P=0.001).Conclusion: This study found no significant predictive relationship between preoperative hematological parameters and postoperative urethrocutaneous fistula development following hypospadias repair. While these hematological factors participated in wound healing, they demonstrated limited clinical utility as reliable prognostic indicators. Future research should prioritize larger multicenter studies and examination of alternative predictive factors influencing surgical outcomes.