A Comparative Study of Polydioxanone (PDS) and Polyglactin (Vicryl) in Hypospadias Repair

Abstract

Background: Hypospadias is a fairly common problem, and it is the most common genital congenital anomaly. Objective: This study was carried out to compare polyglactin and polydioxanone in hypospadias repair by assessing the rate of complications, especially urethrocutaneous fistula (UCF) formation. Patients and Methods: This is a prospective observational cross-sectional hospital-based study carried out at the Department of Paediatric Surgery, Ribat University Hospital, from June 2015 to November 2016. In Group A, there were 55 patients who underwent repair using polyglactin, and in Group B, there were 50 patients who underwent repair using polydioxanone. All patients were operated by the same surgeon. Results: The mean age of Group A was 5.7 ± 4.3 years and 5.1 ± 3.9 years in Group B. Meatal advancement and glanuloplasty incorporated operation was done in 47.6%, Tubularized incised plate urethroplasty in (31.4%), Theirsch-Duplay in 20% and Mathieu's repair in 1%. The complication rate was 34% in Group A and 10.9% in Group B. The most frequent complication was UCF, as 19 patients (18.1%) of the study candidates developed UCF; most of them were in Group A (14 patients) and 5 patients in Group B. Another significant complication was meatal stenosis, which occurred in 11 patients (10.5%): 9 in Group A and 2 in Group B. Conclusion: Polydioxanone (PDS) is satisfactory in hypospadias repair as it is associated with better outcome, especially UCF, which is most common and most difficult to treat complication.

Safety and Effectiveness of Triclosan-Coated Polydioxanone (PDS Plus) versus Uncoated Polydioxanone (PDS II) Sutures for Prevention of Surgical Site Infection after Hypospadias Repair in Children: A 10-Year Single Center Experience with 550 Hypospadias

“…As there is still no definitive agreement on the suture material, many studies have attempted to compare the success and complications of surgery with different suture materials. In a study by Mohamed Ali Alaraby, which showed a lower rate of postoperative complications (34% vs. 10.9%) and better results when using PDS for hypospadias repair, polydioxanone proved to be better than Vicryl [ 11 ]. Another study compared PDS and Vicryl in hypospadias repair and showed that complications occurred more frequently with Vicryl sutures than with PDS sutures (15.1% vs. 5.3%).…”

“…Different surgeons have different preferences as to when the optimal time for surgical correction of this anomaly is, but most agree that it is between the sixth and eighteenth month of life. This consensus has been reached by attempting to balance factors such as age-related genital dimensions and anesthetic risks, as well as the effects of toilet training and the potential psychological consequences of delaying surgery until an age when the child is genitally aware and remembers the procedure [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ].…”

“…Today, there are more than 250 different techniques to correct this anomaly, which shows that there is no ideal technique [ 1 , 8 , 11 ]. The reported complication rate after hypospadias correction is between 5% and 70% [ 1 , 7 ].…”

“…The development of urethrocutaneous fistulas (UCFs) is still the most important postoperative complication of repaired hypospadias and is between 12% and 90%. Healing occurs spontaneously in about 30% of patients, provided there is no distal obstruction [ 8 , 9 , 10 , 11 ]. In general, redo surgery for a complication is usually performed six months after the initial hypospadias repair, unless immediate exploration is indicated by bleeding, infection, or debridement [ 11 ].…”

“…Healing occurs spontaneously in about 30% of patients, provided there is no distal obstruction [ 8 , 9 , 10 , 11 ]. In general, redo surgery for a complication is usually performed six months after the initial hypospadias repair, unless immediate exploration is indicated by bleeding, infection, or debridement [ 11 ].…”