Abstract
Purpose
To review our experience with infants undergoing distal hypospadias repair without a postoperative stent to determine if an unacceptable complication rate might justify its use.
Methods
Children <1 year of age who underwent distal hypospadias repair by a single surgeon were identified through a prospectively maintained database. The use of a postoperative urethral stent was recorded for each case. Demographics, meatus position, operative technique and complications were also recorded. Patients older than 1 year or with hypospadias proximal to a subcoronal position were excluded.
Results
Eighty-nine patients without a stent were identified in addition to 21 patients who had a stent for a minimum of 3 days. At 3 months follow-up, 4/89 (4.49 %) patients in the stentless group required circumcision revision. 1 patient experienced urinary retention. 1/21 (4.76 %) patients with a postoperative stent required reoperation for meatal stenosis.
Conclusions
The complication rate for infants undergoing distal hypospadias repair is low, does not appear to be significantly increased by forgoing a postoperative urethral stent. Avoiding a stent likely reduces a variety of associated adverse events and needs for short-term follow-up.
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References
Ritch CR, Murphy AM, Woldu SL, Reiley EA, Hensle TW (2010) Overnight urethral stenting after tubularized incised plate urethroplasty. Pediatr Surg Int 26:639–642
el-Kassaby AW, Al-Kandari AM, Elzayat T, Shokeir AA (2008) Modified tubularized incised plate urethroplasty for hypospadias repair: long-term results of 764 patients. Urology 71(4):611–615
Baccala AA Jr, Ross J, Detore N, Kay R (2005) Modified tubularized incised plate urethroplasty (Snodgrass) procedure for hypospadias repair. Urology 66(6):1305–1306
Lorenz C, Schmedding A, Leutner A, Kolb H (2004) Prolonged stenting does not prevent obstruction after TIP repair when the glans was deeply incised. Eur J Pediatr Surg 14(5):322–327
Steckler RE, Zaontz MA (1997) Stent-free Thiersch–Duplay hypospadias repair with the Snodgrass modification. J Urol 158:1178–1180
Hakim S, Merguerian PA, Rabinowitz R, Shortliff LD, McKenna PH (1996) Outcome analysis of the modified Mathieu hypospadias repair: comparison of stented and unstented repairs. J Urol 156:836–838
Turial S, Enders J, Engel V, Schier F (2011) Stent-free tubularized incised plate (TIP) repair of distal and mid-shaft hypospadias irrespective of age. Eur J Pediatr Surg 21:168–170
Leclair MD, Camby C, Battisti S, Renaud G, Plattner V, Heloury Y (2004) Unstented tubularized incised plate urethroplasty combined with foreskin reconstruction for distal hypospadias. Eur Urol 46(4):526–530
Snodgrass WT, Nguyen MT (2002) Current technique of tubularized, incised plate hypospadias repair. Urology 60:157–162
Atala A (2002) Urethral mobilization and advancement for mid shaft to distal hypospadias. J Urol 168(4 Pt 2):1738–1741 (discussion 1741)
Duckett JW (1981) MAGPI (meatoplasty and glanuloplasty): a procedure for subcoronal hypospadias. Urol Clin North Am 8(3):513–519
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213
Mustafa NA, Lope RJ, Cheah FC (2006) Spontaneous knot formation impeding the removal of a silicone urethral catheter. Arch Dis Child Fetal Neonatal Ed 91(4):F287
Snodgrass WT (1994) Tubularized, incised plate urethroplasty for distal hypospadias. J Urol 151(2):464–465
El-Sherbiny MT (2003) Tubularized incised plate repair of distal hypospadias in toilet-trained children: should a stent be left? BJU Int 92:1003–1005
Hafez AT, Herz D, Bägli D, Smith CR, McLorie G, Khoury AE (2003) Healing of unstented tubularized incised plate urethroplasty: an experimental study in a rabbit model. BJU Int 91:84–88
Bleustein CB, Esposito MP, Soslow RA, Felsen D, Poppas DP (2001) Mechanism of healing following the Snodgrass repair. J Urol 165(1):277–279
McLorie G, Joyner B, Herz D, McCallum J, Bagli D, Merguerian P, Khoury A (2001) A prospective randomized clinical trial to evaluate methods of postoperative care of hypospadias. J Urol 165(5):1669–1672
Buson H, Smiley D, Reinberg Y, Gonzalez R (1994) Distal hypospadias repair without stents: is it better? J Urol 151(4):1059–1060
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Chalmers, D.J., Siparsky, G.L., Wiedel, C.A. et al. Distal hypospadias repair in infants without a postoperative stent. Pediatr Surg Int 31, 287–290 (2015). https://doi.org/10.1007/s00383-014-3647-y
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DOI: https://doi.org/10.1007/s00383-014-3647-y