Stented versus Non-Stented Snodgrass Urethroplasty for Distal Hypospadia Repair.

Abstract

BACKGROUND:

Hypospadia is one of the most common congenital anomalies in children. Patients with distal hypospadias can be treated successfully with a tubularized incised plate (TIP) urethroplasty, usually with a postoperative urethral stent to divert urine into the diaper or a urine bag for approximately 1 week. However, these stents have their own morbidity and complications. We therefore tried to determine the safety of distal penile hypospadias repair without the use of a postoperative stent.

PATIENTS AND METHOD:

Fifty patients with distal penile hypospadias were prospectively assessed from May 2016 to August 2018. All patients underwent Snodgrass urethroplasty by the same surgeon. Half of the patients had a postoperative stent for 1 week. The other half had no stent. Clinical follow-up was over 6 months with an emphasis on possible stent-related complications.

RESULTS:

Fifty children underwent TIP urethroplasty for distal hypospadia repair. The mean age was 5.9 years (range 2-12). In 25 cases, a stent was removed within 1 week. In the other 25 cases, no postoperative stent was placed. The overall complication rate for the stented group was 48% (n = 12) and for the non-stented group 68% (n = 17), respectively. In the stented group, 1 patient (4%) developed a fistula, whilst there were 2 (8%) in the non-stented group. All fistulas were repaired after 6 months postoperatively. Neourethral stenosis and glans dehiscence occurred in each 1 case (4%) in both groups. Differences were not statistically significant. However, there were significantly more wound infections in the stented group. On the other hand, stents prevented temporary urinary retention which occurred in 2 patients in the non-stented group.

CONCLUSION:

Despite the limited number of cases, our study suggests that, all in all, there is no significant difference in severe complication rates regardless whether a postoperative stent is used or not.

• Authors: Murtadha Almusafer, Osama Hussein Abduljabbar, Noor Buchholz
• Journal: Urologia internationalis (Urol Int) Vol. 104 Issue 1-2 Pg. 156-159 ( 2020) ISSN: 1423-0399 [Electronic] Switzerland
• PMID: 31715616 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2019 S. Karger AG, Basel.

Topics

• Child
• Child, Preschool
• Cross-Sectional Studies
• Humans
• Hypospadias (surgery)
• Male
• Penis (surgery)
• Postoperative Period
• Prospective Studies
• Plastic Surgery Procedures
• Stents
• Treatment Outcome
• Urinary Retention (prevention & control)
• Urologic Surgical Procedures (instrumentation, methods)