Dribbling Diversion in Y‐V Glanuloplasty Modified Mathieu Repair

Fathi, Khaled; Pintér, Andrew

doi:10.1055/s-2008-1039198

Cited by 10 publications

(4 citation statements)

References 3 publications

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“…Nevertheless, some argue the need for a urethral catheter or stent, as non-catheter repair has higher complication rates. Others have found that the urethral catheter does have the advantage of preventing urinary retention and early urethrocutaneous fistula after the repair [10,11,12]. Thus, the decision depends on the individual surgeon's preference and there has been little scientific evidence behind the choice.…”

Section: Introductionmentioning

confidence: 99%

Outcome Analysis of Tubularized Incised Plate Repair in Hypospadias: Is a Catheter Necessary?

Xue²,

Wei³

et al. 2013

Urol Int

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Objective: Tubularized incised plate (TIP) urethroplasty is performed by many pediatric urologists and has been widely accepted for repair of distal and mid-shaft hypospadias. However, the role of urethral catheter placement in TIP repair remains controversial. In this study, the surgical outcomes of indwelling urethral catheter and non-catheter TIP repairs in boys with hypospadias were compared. Methods: A total of 254 patients with primary distal and mid-shaft hypospadias underwent TIP repair and were evaluated retrospectively. A urethral catheter was placed in 103 patients (group A) and non-catheter repair was performed in 151 patients (group B). Information obtained included age, toilet training, chordee, type of hypospadias, presence or absence of a catheter, and postoperative complications. The complications recorded included wound infection, urinary tract infection, bladder spasm, urinary retention, urinary extravasation, meatal stenosis, urethral stricture, and urethrocutaneous fistula. Results: There was no statistical difference in age, toilet training, chordee, hypospadias site, or performing surgeon between the two groups. The median follow-up time was 22 and 24 months for groups A and B, respectively. The rate of bladder spasms (10.7 vs. 0%, p < 0.001) and urinary tract infection (9.7 vs. 3.3%, p = 0.034) was significantly higher for group A than group B. Although the rate of urinary retention was higher in group B than in group A (4.0 vs. 0%), there was no statistically significant difference between the two groups (p = 0.084). Likewise, the incidence of urethrocutaneous fistula and meatal stenosis was not significantly different. Conclusion: Non-catheter TIP repair is feasible and positive outcomes can be achieved with minimal complications and less patient discomfort.

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Section: Introductionmentioning

confidence: 99%

Outcome Analysis of Tubularized Incised Plate Repair in Hypospadias: Is a Catheter Necessary?

Xue²,

Wei³

et al. 2013

Urol Int

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“…Rich et al demonstrated that long-term results with overnight stenting for patients with distal and mid-penile hypospadias were similar to reported data [19]. In animal studies [16][17][18][19][20][21], it has been shown that in Snodgrass repair tissue healing starts by re-epithelialization of the incised plate. For partial reepithelialization five days and for complete epithelialization and normal urothelium two weeks are required [16].…”

Section: Discussionmentioning

confidence: 65%

A Comparative Study on the Outcomes of Hypospadias Surgery Following Early Versus Late Bladder Catheter Removal

Kumar¹,

Dhayal²

2022

Cureus

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BackgroundHypospadias is the most common penile malformation affecting up to one in 300 live male births. In general, a urinary diversion (urethral stent or bladder catheter) is maintained in situ for two to seven days or more after hypospadias repair. Because of the low level of evidence, the latest guidelines of the European Association of Urology and the European Society of Paediatric Urology provide no recommendations concerning the timing of catheter removal after hypospadias surgery. In this study, we aimed to compare the outcomes of hypospadias surgery (tubularized incised plate urethroplasty, TIPU) following early versus late bladder catheter removal. MethodologyIn total, 62 patients were included in this study. All patients underwent TIPU by the same team of surgeons. All patients were divided into the following two groups: group A (32 patients) had their catheter removed on or before the fifth postoperative day, and group B (30 patients) had their catheter removed after the fifth postoperative day. All patients were scheduled for an outpatient assessment after two weeks, at one month, after three months, and at six months if necessary. ResultsThe mean age of patients in group A was five years (three to seven years) and in group B was five years (four to 7.25 years) with a p-value of 0.378. Among the early complications of the surgery, the occurrence of wound infections, urinary tract infections, and urinary retention was comparable among the two groups. The rate of bladder spasms (0% versus 13.3%, p = 0.033) was significantly higher in group B than in group A. The rate of urinary retention (12.5% versus 0%, p = 0.045) was significantly higher in group A than in group B. Superficial wound infection occurred in two out of 32 patients in group A (6.3%) and two out of 30 patients in group B (6.7%) (p = 0.94). Both groups had similar incidences of wound complications. Urinary tract infections also had a similar incidence in both early and late catheter removal groups, i.e., one out of 32 patients in group A (3.1%) and three out of 30 patients (10%) in group B (p = 0.271). Urinary extravasation following hypospadias repair occurred in two out of 32 patients (6.3%). No extravasation was noted in the late catheter removal group. However, the difference was not clinically significant (p = 0.164). Two patients in both groups developed urethrocutaneous fistula (6.3% in group A versus 6.7% in group B). However, the difference was not clinically significant. Meatal stenosis developed in three out of 32 patients in group A and two out of 30 patients in group B (9.4% versus 6.7%; p = 0.696). One patient in the early catheter removal group developed urethral stricture as a late complication. None of the patients in the late catheter removal group developed this complication. ConclusionsThe occurrence of long-term complications of TIP hypospadias repair was not affected by the early removal of the bladder catheter. The shortcomings of our study were its descriptive nature and the small sample size. Further prospective r...

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“…There was no stenosis of the urethral meatus in either group of patients. Fathi and Pintér [14] evaluated the impact of an indwelling transurethral catheter on surgical outcome and postoperative micturation with Y-V glanuloplasty modified Mathieu repair for primary hypospadias. They reported that a transurethral catheter avoids distressing postoperative micturation and minimizes the chance of urethrocutaneous fistula and meatal stenosis.…”

Section: Discussionmentioning

confidence: 99%

Y-V Glanuloplasty Modified Mathieu Technique With Versus Without a Urethral Stent in the Management of Distal Hypospadias

Shelbaia¹,

Hussein²

2011

UIJ

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INTRODUCTION:Reported complication rates from the Y-V glanuloplasty modification to the Mathieu technique have varied and may be related, at least in part, to inconsistent use of the recommended stent. The purposes of the present investigation were to: (1) describe the intraoperative and postoperative complications associated with the Y-V glanuloplasty modification, and (2) compare results from patients receiving a stent with patients not receiving a stent. METHODS:A total of 56 patients with distal hypospadias were included in this prospective study. Their mean age was 4.5 years (range, 3-8 years). All patients had a Y-V glanuloplasty modified Mathieu technique. They were randomly divided into 2 groups: group 1 (n = 30) had surgery without a urethral stent; group 2 (n = 26) had surgery with insertion of a 10 Fr urethral catheter (Nelaton draining catheter) down to the bladder. The stent was removed 5 days postoperatively. Follow-up evaluation occurred 5-7 days after surgery and then monthly for 12 months and every 3 months for 2 years. Complications were recorded at each visit and compared between groups. RESULTS:A total of 13 patients (43%) in group 1 (without a stent) had complications that included dysuria (n = 10), edema of the glans that resolved after a few days (n = 2), and secondary bleeding due to severe infection and rupture of the flap that required reoperation (n = 1). A total of 7 patients (27%) in group 2 (with a stent) had complications. After removal of the stent, 4 patients had urgency and 3 patients had dysuria that disappeared after few days. None of the patients with a stent had infection or edema of the glans. At the end of the follow-up period, all patients in both groups were in good condition, with the neomeatus located at the tip of the glans.There were no long-term complications. CONCLUSIONS: Y-V glanuloplasty modified Mathieu technique with meticulous subcuticular sutures has a high success rate and is suitable for distal hypospadias. Based on our results and those of previous studies, we do not recommend a catheterless technique. UroToday International Journal ® UI J

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Dribbling Diversion in Y‐V Glanuloplasty Modified Mathieu Repair

Abstract: An indwelling transurethral catheter obviates urinary retention and avoids distressing postoperative micturation. It minimises the chance of urethrocutaneous fistula and meatal stenosis in Y-V glanuloplasty modified Mathieu repair.

Cited by 10 publications

References 3 publications

Outcome Analysis of Tubularized Incised Plate Repair in Hypospadias: Is a Catheter Necessary?

Outcome Analysis of Tubularized Incised Plate Repair in Hypospadias: Is a Catheter Necessary?

A Comparative Study on the Outcomes of Hypospadias Surgery Following Early Versus Late Bladder Catheter Removal

Y-V Glanuloplasty Modified Mathieu Technique With Versus Without a Urethral Stent in the Management of Distal Hypospadias

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