Urethral catheterization in hypospadias surgery: Should the device enter the bladder or be made a urethral stent?

Although bladder catheterization causes contractions, accidental removal and urinary retention are risks of stents in hypospadias repair.

An 8F feeding tube was used as a stent in 22 patients (group I). In the other 22 patients (group II), the same size catheter was passed into the bladder, and oxybutynin chloride was administered. The elapsed time to first voiding, pain, and straining was observed in group I and the groups were compared regarding time of catheter removal, accidental removal of catheter/stent, hospital stay, and complications.

All stented patients strained at first voiding. Nineteen showed pain, and only 5 voided in the first 8 hours. The catheterized group had no such problems. Time of catheter/stent removal and hospital stay were similar. Three stents were dislodged in patients with significant straining. Meatal stricture was noticed in 5 and 3 patients and fistula in 5 and 2 patients of group I and II, respectively. Complications were significant in patients whose stents were removed accidentally.

Stenting led to significant patient irritability with voiding problems. The authors believe that this caused displacement and accidental removal of the stent and eventually resulted in meatal stenosis and fistula. The findings show that bladder catheterization prevents these complications. J Pediatr Surg 36:1829-1831.