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A new suture material for hypospadias surgery: a comparative study
Nino Guarino1, Santiago Andres Vallasciani, Giacinto Marrocco
1Division of Pediatric Surgery, Ospedale San Camillo-Forlanini, Rome, Italy.
Insights
Polyglytone sutures offer a faster absorption rate than polydioxanone for hypospadias repair, leading to fewer long-term suture tracks. Both materials are effective for pediatric hypospadias surgery, with no significant difference in fistula rates.
Area of Science:
- Pediatric Urology
- Surgical Innovation
- Biomaterials Science
Background:
- Hypospadias repair in infants requires careful suture selection for optimal outcomes.
- Suture material choice impacts wound healing and long-term cosmetic results.
- Rapidly absorbing sutures may reduce complications like suture tracks.
Purpose of the Study:
- To compare polyglytone and polydioxanone sutures in hypospadias repair.
- To evaluate the benefit of rapid suture absorption time.
- To assess long-term outcomes including fistula and suture track formation.
Main Methods:
- 100 male infants (8-24 months) with distal hypospadias underwent tubularized incised plate repair.
- Patients were randomized to receive either polyglytone (Group A) or polydioxanone (Group B) sutures.
- Outcomes including fistula, dehiscence, infection, and suture persistence were assessed at 1 week, 1 month, 6 months, and 2 years.
Main Results:
- No significant differences were found in urethral fistula rates, skin dehiscence, or acute infection between groups.
- Polyglytone sutures showed significantly less persistence on penile skin and fewer long-term suture tracks compared to polydioxanone.
- Long-term follow-up revealed a higher incidence of suture tracks in the polydioxanone group.
Conclusions:
- Both polyglytone and polydioxanone are suitable for pediatric hypospadias repair.
- Polyglytone's rapid absorption minimizes long-term suture tracks, improving cosmetic outcomes.
- The tensile strength of polyglytone is adequate, as evidenced by comparable fistula rates.
Purpose:
We compared the results of hypospadias repair using polyglytone versus polydioxanone to evaluate the potential benefit of using a suture with a rapid absorption time.
Materials And Methods:
A total of 100 patients 8 to 24 months old affected by distal isolated penile hypospadias were considered for this study. Patients were randomized and assigned to 2 different groups according to the suture material used during the surgical procedure (tubularized incised plate repair with or without preputial reconstruction). Polyglytone was used in group A and polydioxanone was used in group B. All patients were evaluated at 4 intervals (1 week, 1 month, 6 months and 2 years postoperatively). Persistence of sutures on penile skin, urethral fistulas, skin dehiscence, infection and skin tracks were recorded. Statistical analysis was performed using chi-square test.
Results:
Followup data documented the absence of significant differences in terms of urethral fistula rate, skin dehiscence and acute skin infection. Persistence of sutures and multiple skin tracks at long-term followup were significantly greater in patients in group B.
Conclusions:
Both sutures are adequate for hypospadias surgery in small children. The use of a rapid absorption monofilament may allow much more rapid disappearance of the skin sutures. In the long term this outcome means almost complete absence of suture tracks. No statistically significant difference in terms of urethrocutaneous fistula was observed, suggesting that the tensile strength of polyglytone is adequate.
