Tubeless Barcat: a patient-friendly hypospadias procedure

To determine whether the distinct advantages of a catheter-free hypospadias repair can be obtained with a Barcat procedure without an adverse effect on surgical outcome.

A retrospective review was performed on consecutive patients who had undergone a catheter-free Barcat repair from July 1998 to May 2002. Patient records were examined for information regarding age, meatal location, primary or secondary procedure, operative time, postoperative follow-up, and complications.

Thirty-six consecutive catheter-free Barcat hypospadias repairs were performed in the review period. Patient age ranged from 6 months to 9 years (mean 26 months). All patients either had a coronal meatus or a subcoronal meatus. Thirty-three patients (92%) underwent a primary repair. Three patients (8%) underwent the repair as a secondary procedure after a previous failed procedure. The mean follow-up was 25 months. One patient required a single catheterization in the immediate postoperative period for urinary retention. Another patient had glans separation and meatal retrusion requiring a revision procedure. All the other patients achieved a satisfactory cosmetic result with an orthotopic slit-like meatus.

The Barcat hypospadias repair may be performed in patients with distal hypospadias without the use of a postoperative urethral catheter. Foregoing a catheter had no adverse effect on the surgical outcome with reduced patient discomfort.