The Role of Waterproofing Layer in Single Stage Hypospadias Repair: A Prospective Study

Abstract

To study the comparative result of hypospadias repair by dividing the patients in two groups (a) hypospadias repair with waterproofing layer by one of the technique of hypospadias repair.(b) hypospadias repair without waterproofing, and evaluate the complication rates between these two groups especially in reference to incidence of urethrocutaneous fistula. MATERIAL AND METHODS: A prospective study done in the regional institute of surgery and pediatrics, M.L.B. Medical College, Jhansi during 2010 to 2013 with complain of location of urethral meatus on undersurface of penis i.e. hypospadias on 18 cases. RESULT: In the present study, most of our cases (83.33) were of less than 8 years of age. Most common type was middle hypospadias (50%), followed by proximal (27.77%) and distal (22.22%). Chordee was present in 66.66% of our cases.11.11% cases had penile torsion in pre-operative period. Asopa technique was used in cases with significant chordee and Snodgrass technique used in cases without significant chordee. Urethral plate was well formed and grooved in 66.66% cases, shallow in 27.77% cases and distorted in 5.55% cases. Waterproofing of neourethra was done in 55.55% cases, 44.44% cases were without Water proofing layer. Without Water proofing group had better cosmetic results(87.5%) than with Water proofing (70%) but more chances of metal stenosis and skin flap necrosis that leads to urethrocutaneous fistula formation. So Waterproofing decrease the chances of metal stenosis and skin flap necrosis with poor cosmetic results.