Post-operative complications of subcoronal hypospadias repair in patients receiving caudal block vs. penil block: A comparative study




Caudal block, Hypospadias, Pediatric, Penile block, Regional nerve block


Objective: The aim of this study was to evaluate the potential impact of caudal nerve block anesthesia on the surgical outcomes of hypospadias repair in male patients aged between 6 and 48 months.

Materials and methods: The study successfully recruited 75 patients dividing two groups, group 1 (Penil block: PB) and group 2 (Caudal block: CB). The following parameters were assessed for each patient: Age, duration of surgery, analgesia requirements, wound dehiscence, fistula formation, meatal stenosis, urethral diverticula, and urethral stricture.

Results: This study involving 75 patients divided into two groups, Group 1 (40 patients) had an average age of 38±23 months and weight of 14.6±4.8 kg, while Group 2 (35 patients) averaged 42±19 months in age and 17.1±8.2 kg in weight. Operative times were comparable between groups. Post-operatively, around 45-49% of participants in both groups required further analgesia within 24 hours. Observations of surgical complications, including fistula, meatal stenosis, urethral stenosis, urethral diverticula, urethral dehiscence, and Chordee, revealed minor variations between groups. However, none of these differences reached statistical significance, indicating similar outcomes for both groups (p>0.05 for each comparison).

Conclusions: Both anesthetic techniques appear safe, and the choice should be based on individual clinical judgment and patient-specific factors.


Splinter WM, Kim J, Kim AM, Harrison MA. Effect of anesthesia for hypospadias repair on perioperative complications. Paediatr Anaesth. 2019;29(7):760-7.

Karaca O, Pinar HU, Gokmen Z, Dogan R. Ultrasound-Guided versus Conventional Caudal Block in Children: A Prospective Randomized Study. Eur J Pediatr Surg. 2019;29(6):533-8.

Hassan PF, Hassan AS, Elmetwally SA. Caudal Analgesia for Hypospadias in Pediatrics: Comparative Evaluation of Adjuvants Dexamethasone and Dexmedetomidine Combination versus Dexamethasone or Dexmedetomidine to Bupivacaine: A Prospective, Double-Blinded, Randomized Comparative Study. Anesth Essays Res. 2018;12(3):644-50.

Hecht S, Piñeda J, Bayne A. Ultrasound-guided Pudendal Block Is a Viable Alternative to Caudal Block for Hypospadias Surgery: A Single-Surgeon Pilot Study. Urology. 2018;113:192-6.

Polaner DM, Almenrader N, Vemulakonda V. Caudal analgesia, hypospadias, and urethrocutaneous fistula: Does association mean causality? Paediatr Anaesth. 2017;27(7):676-7.

Kundra P, Yuvaraj K, Agrawal K, Krishnappa S, Kumar LT. Surgical outcome in children undergoing hypospadias repair under caudal epidural vs penile block. Paediatr Anaesth. 2012;22(7):707-12.

Taicher BM, Routh JC, Eck JB, Ross SS, Wiener JS, Ross AK. The association between caudal anesthesia and increased risk of postoperative surgical complications in boys undergoing hypospadias repair. Paediatr Anaesth. 2017;27(7):688-94.

Kendigelen P, Tutuncu AC, Emre S, Altindas F, Kaya G. Pudendal Versus Caudal Block in Children Undergoing Hypospadias Surgery: A Randomized Controlled Trial. Reg Anesth Pain Med. 2016;41(5):610-5.

Karagözlü Akgül A, Canmemiş A, Eyvazov A, Hürel H, Kiyan G, Umuroğlu T, et al. Effects of Caudal and Penile Blocks on the Complication Rates of Hypospadias Repair. Balkan Med J. 2022;39(4):239-45.

Pfistermuller KL, McArdle AJ, Cuckow PM. Meta-analysis of complication rates of the tubularized incised plate (TIP) repair. J Pediatr Urol. 2015;11(2):54-9.

Tanseco PP, Randhawa H, Chua ME, Blankstein U, Kim JK, McGrath M, et al. Postoperative complications of hypospadias repair in patients receiving caudal block vs. non-caudal anesthesia: A meta-analysis. Can Urol Assoc J. 2019;13(8):E249-E257.

Adler AC, Chandrakantan A, Lee AD, Koh CJ, Janzen NK, Austin PF. Effect of Caudal vs. Penile Block on the Incidence of Hypospadias Complications Following Primary Repairs: A Retrospective Cohort Study. J Urol. 2021;205(5):1454-9.

Ngoo A, Borzi P, McBride CA, Patel B. Penile nerve block predicts higher revision surgery rate following distal hypospadias repair when compared with caudal epidural block: A consecutive cohort study. J Pediatr Urol. 2020;16(4):439.e1-439.e6.

Kim MH, Im YJ, Kil HK, Han SW, Joe YE, Lee JH. Impact of caudal block on postoperative complications in children undergoing tubularised incised plate urethroplasty for hypospadias repair: a retrospective cohort study. Anaesthesia. 2016;71(7):773-8.

Braga LH, McGrath M, Farrokhyar F. Dorsal penile block versus caudal epidural anesthesia effect on complications post-hypospadias repair: Dilemmas, damned dilemmas and statistics. J Pediatr Urol. 2020;16(5):708-11.

Zhu C, Wei R, Tong Y, Liu J, Song Z, Zhang S. Analgesic efficacy and impact of caudal block on surgical complications of hypospadias repair: a systematic review and meta-analysis. Reg Anesth Pain Med. 2019;44(2):259-67.



How to Cite

Sagir S. Post-operative complications of subcoronal hypospadias repair in patients receiving caudal block vs. penil block: A comparative study. J Clin Trials Exp Investig [Internet]. 2023 Aug. 5 [cited 2023 Oct. 4];2(3):159-63. Available from: