Does the suturing technique (continuous versus interrupted) have an impact on the outcome of tubularized incised plate in hypospadias repair with adequate urethral plate? A prospective randomized study

Samir, Mohamed; Mahmoud, Mahmoud Ahmed; Azazy, Samir; Tawfick, Ahmed

doi:10.1016/j.jpurol.2021.04.021

Cited by 12 publications

(13 citation statements)

References 26 publications

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“…Five studies[ 6 , 7 , 9 , 15 , 16 ] met our inclusion criteria, including 521 children (258 in the CS group and 263 in the IS group).…”

Section: Resultsmentioning

confidence: 99%

“…A trial by Samir et al . [ 6 ] has shown a low risk of bias across random sequence generation, blinding of outcome assessment, and selective reporting. Gupta et al .…”

Section: Resultsmentioning

confidence: 99%

“…[ 5 ] reported no difference in outcomes regardless of the suturing technique, results from other authors such as Samir et al . [ 6 ] and Gafar et al . [ 7 ] have incited us to look into the significance of suturing technique.…”

Section: Introductionmentioning

confidence: 99%

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The comparison of interrupted and continuous suturing technique in Snodgrass urethroplasty in patients with primary hypospadias: A systematic review and meta-analysis

et al. 2022

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Background: Hypospadias is among the common congenital anomalies in boys. Snodgrass urethroplasty is one of the most popular techniques for correcting distal and mid hypospadias. Although there is consensus among pediatric surgeons on using absorbable sutures for urethroplasty, there are no established guidelines about the suturing techniques (interrupted suturing [IS] or continuous suturing [CS]) for neourethra creation in Snodgrass urethroplasty. This analysis aims to compare the reported outcomes of both the urethroplasty suturing techniques. Materials and Methods: This systematic review and meta-analysis was conducted as per the preferred reporting items for systematic review and meta-analyses guidelines. A systematic, detailed search was carried out by the authors in the electronic databases – MEDLINE, PubMed Central, Scopus, Google Scholar, and Clinical Trial Registry. Studies were selected and compared based on primary outcomes – development of urethrocutaneous fistula (UCF), meatal stenosis, and secondary outcomes – wound infection, urethral stricture, and operative time. Statistical analysis was performed using a fixed-effect model, pooled risk ratio, and I 2 heterogeneity. Results: Five randomized studies with a total of 521 patients met our inclusion criteria. Pooled analysis for total complications, UCF, meatal stenosis, and wound infection showed no significant difference between the CS and IS groups. Subgroup analysis of patients with the use of polyglactin sutures showed a decrease in total complications and UCF in the IS group. Conclusion: There is no difference in total complication rates among the CS and the IS group with the use of absorbable sutures in Snodgrass urethroplasty; however, there is a decrease in the incidence of total complications and UCF in the IS group when polyglactin was preferred over polydioxanone suture for urethroplasty.

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“…Five studies[ 6 , 7 , 9 , 15 , 16 ] met our inclusion criteria, including 521 children (258 in the CS group and 263 in the IS group).…”

Section: Resultsmentioning

confidence: 99%

“…A trial by Samir et al . [ 6 ] has shown a low risk of bias across random sequence generation, blinding of outcome assessment, and selective reporting. Gupta et al .…”

Section: Resultsmentioning

confidence: 99%

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The comparison of interrupted and continuous suturing technique in Snodgrass urethroplasty in patients with primary hypospadias: A systematic review and meta-analysis

et al. 2022

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“…Most of these techniques are constantly being revised and modified in order to achieve ideal results, as the rate of postoperative complications remains high. To reduce the incidence of urethrocutaneous fistula, scholars worldwide have been developing and improving surgical technologies and styles, such as individual procedures during perioperative treatment (11)(12)(13). It is reported that the preoperative application of HCG and dihydrotestosterone ointment can improve the appearance of the penis and reduce the incidence of complications (14,15).…”

Section: Discussionmentioning

confidence: 99%

Application of Allogeneic Human Acellular Dermal Matrix Reduces the Incidence of Fistula in Hypospadias Repair

Yang

et al. 2022

Front. Pediatr.

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BackgroundUrethrocutaneous fistula is one of the most common complications arising from hypospadias surgery. The purpose of our study was to investigate the effectiveness and safety of allogeneic human acellular dermal matrix (HADM) application as a means of preventing the occurrence of urethrocutaneous fistula following hypospadias surgery.MethodsThis is a non-randomized study of 219 cases (out of 270 patients with hypospadias) which satisfied inclusion and exclusion criteria. These patients were divided into two groups: 101 HADM patients, and 118 control patients (who did not receive HADM). In the control group, 77 boys were treated by single-stage urethroplasty (TIP) and 41 underwent staged urethroplasty (Thiersch-Duplay). In the HADM group, 59 boys underwent the TIP and 42 underwent the Thiersch-Duplay. In the postoperative period, we recorded the incidence of infection, urethrocutaneous fistula, and urethral stricture complications in these two groups of patients. The effectiveness and safety of HADM in preventing urethrocutaneous fistula following hypospadias surgery were evaluated according to these indicators.ResultsIn the control group, following the operation there were 16 cases of infection, 38 cases of urethrocutaneous fistula after extubating, and 5 cases of urethral stricture. In the HADM group, there were 19 cases of postoperative infection, 12 cases of urethrocutaneous fistula after extubating, and 5 children with urethral stricture. In comparing the two groups, it was found that the postoperative infection rate (13.6 vs. 18.8%) and the incidence of urethral stricture (4.2 vs. 5.0%) were not statistically significant (P > 0.05), while the postoperative urethrocutaneous fistula rate (32.2 vs. 11.9%) was statistically significant (P < 0.001).ConclusionIt is found that HADM application can significantly reduce the incidence of urethrocutaneous fistula complications, without increasing the risk of infection and urethral stricture.

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“…Samir et al conducted a prospective trial to compare the outcome of interrupted suture and continuous suture in hypospadias repair using TIP technique. Their result showed that the interrupted sutures groups was associated with a lower complication rate [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

A new modified Duckett urethroplasty for repair of proximal hypospadias with severe chordee: outcomes of 133 patients

Wang

Zhang

et al. 2022

BMC Urol

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Background Despite the continuous development and evolution of surgical methods and techniques, proximal hypospadias remains one of the most challenging issues for pediatric urologists. This study aims to evaluate the indications and postoperative complications of our new modified Duckett urethroplasty. Methods A total of 133 patients with proximal hypospadias who underwent repair of the modified Duckett urethroplasty from February 2016 to February 2021 were reviewed. The median age of patients was 3 years (range 1–16). All patients had severe chordee. One senior experienced pediatric urologist performed all the surgeries. Catheter was removed 14 days after the surgery. Results The location of the urethral meatus was proximal penile in 26 patients (19.5%), penoscrotal in 60 (45.1%), scrotal in 31 (23.3%), and perineal in 16 (12.0%). The mean length of the urethral defect was 4.5 cm (range 2.5–10). The median duration of follow-up was 46 months (range 8–67). Complications occurred in 31 patients (23.3%), including urethra-cutaneous fistula in 22 (16.5%), urethral stenosis in 7 (5.3%), and urethral diverticulum in 2 (1.5%). No recurrent chordee were found in all cases. All patients who developed complications were treated successfully at our hospital. Conclusions Our modified Duckett urethroplasty showed functionally and cosmetically favorable outcomes, with a lower incidence of postoperative complications. To the best of our knowledge, the novel Duckett technique is a feasible and suitable option for patients who suffer from proximal hypospadias with severe chordee and dysplasia of the urethral plate.

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Does the suturing technique (continuous versus interrupted) have an impact on the outcome of tubularized incised plate in hypospadias repair with adequate urethral plate? A prospective randomized study

Cited by 12 publications

References 26 publications

The comparison of interrupted and continuous suturing technique in Snodgrass urethroplasty in patients with primary hypospadias: A systematic review and meta-analysis

The comparison of interrupted and continuous suturing technique in Snodgrass urethroplasty in patients with primary hypospadias: A systematic review and meta-analysis

Application of Allogeneic Human Acellular Dermal Matrix Reduces the Incidence of Fistula in Hypospadias Repair

A new modified Duckett urethroplasty for repair of proximal hypospadias with severe chordee: outcomes of 133 patients

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