Comparison of interrupted- and continuous-suture urethroplasty in tubularised incised-plate hypospadias repair: A prospective study

Abstract

ObjectiveTo compare the effect of interrupted- and continuous-suture urethroplasty on complication rates in Snodgrass tubularised incised-plate (TIP) hypospadias repair.Patients and methodsThis was a prospective randomised study comprising 100 boys (age range 1–5 years) with primary subcoronal, distal- and mid-penile hypospadias who underwent repair from October 2010 to March 2015 in a tertiary care hospital. Boys with glanular, recurrent, and proximal hypospadias were excluded from the study. The boys were prospectively randomised into two groups: Group A, comprised 50 boys who underwent interrupted subcuticular suture Snodgrass TIP urethroplasty; and Group B, comprised 50 boys who underwent continuous subcuticular suture Snodgrass TIP urethroplasty. Outcomes were assessed in terms of complication rates and aesthetic appearance during follow-up.ResultsThere was no significant difference in the occurrence of complications between the groups. There were 21 complications, with 10 occurring in Group A and 11 in Group-B. Urethrocutaneous fistula was the most common complication in both groups (six in Group A and seven in Group B), the fistulae were <2 mm in nine patients and 3–5 mm in the remaining four. Partial glans dehiscence occurred in one patient in each group. One patient from each group also had superficial wound infection, meatal stenosis and urethral stricture respectively, all of which were managed conservatively. The resultant urinary stream was single and good in all patients of both groups.ConclusionsThe type of suture technique had no significant effect on complication rates after Snodgrass hypospadias repair and thus the choice of technique depends on surgeon preference.

Tabularised Incised Plate (TIP) Urethroplasty in Narrow V/S Wide Urethral Plate: A Comparative Study in a Developing Country Perspective

“…Chukwubuike, et al reported a 31% complication rate for distal and mid shaft hypospadias in Nigeria [2]. Gupta, et al reported a 21% complication rate with 13% UC fistula rate in their 100 patients of TIP repair in India [6]. Elbakry, et al reported a 16.8% complication rate in their 172 patients of distal hypospadias who underwent TIP repair in Egypt [4].…”

“…Tubularized incised plate (TIP) urethroplasty has become an attractive method worldwide for hypospadias repair since its introduction in 1994 for distal hypospadias and 1998 for mid shaft and proximal hypospadias [1]. Although reports from developed world show excellent outcome of this procedure, the descriptions from many developing countries still show more fistula rates and other complications [2][3][4][5][6]. Moreover, there is still debate about the ultimate outcome of incising a urethral plate and the application of TIP where the urethral plate is narrow.…”

Internal urethral stent (Lasheen urethral stent) for hypospadias repair

“…The aim of all hypospadias repair procedures is to reconstruct functional neo-urethra with normal anatomy of penis, the TIP method achieved this goal [11,12]. The common complications of hypospadias repair procedures are failure, fi stula, and meatal stenosis in percentage ranging from 0 to 33 % [13,14].…”

Long-Term Results of Modified Connell Suture Technique in Repair of Distal and Mid Penile Hypospadias

“…Bununla beraber, neoüretra aşamasında kullanılan sütür tekniğinin sonucu etkilemediğini bildiren araştırmalarda bulunmaktadır (9). Diğer yandan, subkütiküler ve tam kat sütür atılmasının cerrahi sonuçlarını değiştirmediğini bildiren çalışmalarda vardır (8). Bu çalışmaların aksine olgularımızda Modifiye Connell sütür tekniği ile "watertight" bir hat oluştuğu; buna bağlı olarak da cerrahi başarının yüksek oranda gerçekleştiği sonucuna varılmıştır.…”

“…Bununla beraber, neoüretra aşamasında kullanılan sütür tekniğinin sonucu etkilemediğini bildiren araştırmalarda bulunmaktadır (9). Diğer yandan, subkütiküler ve tam kat sütür atılmasının cerrahi sonuçlarını değiştirmediğini bildiren çalışmalarda vardır (8)…”