Tourniquet and adrenaline use in hypospadias surgery: a survey on the current practice in Turkey

Özet

Objective: Aim of the study is to determine the hemostatic techniques among pediatric urologists in Turkey.Material and methods: Questionnaire forms were sent to 459 pediatric urologist by e-mail.Results: Ninety eight of 459 participants answered the questionnaire forms. Eighty-one (84.4%) of theparticipants were using tourniquet. The participants who didn’t use tourniquet stated their justifications asfollows: lack of need (n=10: 66.7%), development of edema, ischemia, delay of wound-graft healing andfistula risk (n=5: 33.3%). The indications of tourniquet use were stated as follows: penile (91.4%: n=74),distal (72.8%: n=59), penoscrotal (55.6%: n=45) hypospadias; fistula repair (33.3%: n=27), cripple hypospadias (33.3%: n=27), repair with flaps (30.9%: n=25), repair with grafts (27.2%: n=22), and isolated penilecurvature (21%: n=17). Most commonly used tourniquet material (49.9%) was latex glove. Erection test wasapplied by 43.8% of participants. Scalp vein set was the most commonly (54.8%) used injector during erection test. Only 9.4% of participants were using adrenaline. Adrenaline dosages used at 1/100.000 dilution by55.6%, lidocaine with 1/100.000 adrenaline by 44.4% of participants.Conclusion: Beside a few experimental ones there is a paucity of studies that can serve as a guideline for using these techniques in the literature. There is a necessity of realizing prospective, randomized studies withlong-term follow up to evidence that postoperative complications could develop secondary to hemostatictechniques and also to facilitate safe use of these techniques.