A Thorough Analysis of The Effects and Complications of Two Different Suturing Techniques in Hypospadias Repair Using Tubularized-Incised Plate Urethroplasty: a Meta-Analysis

Abstract

Background: Hypospadias is a male congenital anomaly that requires urethroplasty via the tubularized-incised plate (TIP) technique. This technique is simple, and the results are promising, although it has few postoperative complications, including the associated suture technique. Objective: Comparing the continuous and interrupted suturing techniques on the TIP procedure for hypospadias repair. Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The authors thoroughly searched electronic databases of PubMed, Scopus, ScienceDirect, and Web of Science. The compared endpoints were the total complication, wound infection, meatal stenosis, glans dehiscence, and urethral stricture presented as risk ratio (RR), with average operating time as mean difference (MD), in 95% confidence intervals (CIs). All statistical analyses were performed using Revman 5.4. Results: Ten eligible studies were included, totalling 1,894 patients. Pooled RR showed no significant difference in overall complication, surgical site infection, meatal stenosis, glans dehiscence, and urethral stricture between continuous and interrupted sutures. In subgroup analysis, the interrupted suture had fewer complications when using polyglactin material (RR: 1.51, 95% CI 1.07 to 2.14; p = 0.02). The continuous suture showed lesser operative time than the interrupted suture (MD: -6 .67, 95% CI -12.52 to -0.82; p = 0.03). Discussion and Conclusion: No significant complication difference existed between continuous and interrupted suturing techniques. Fewer complications were obtained when using interrupted sutures with polyglactin material. However, continuous suture required less operative time.