Overnight urethral stenting after tubularized incised plate urethroplasty for distal hypospadias
Chad R Ritch1, Alana M Murphy, Solomon L Woldu
1Division of Pediatric Urology, Department of Urology, Morgan Stanley Children's Hospital of New York, Presbyterian, Columbia University College of Physician and Surgeons, 3959 Broadway, New York, NY 10032, USA. cr2314@columbia.edu
Insights
Overnight urethral stenting after tubularized incised plate (TIP) hypospadias repair is safe for primary cases. This approach does not significantly increase complication rates like urethrocutaneous fistula, meatal stenosis, or UTIs.
Area of Science:
- Pediatric Urology
- Surgical Outcomes
- Hypospadias Repair
Background:
- The duration of urethral stenting post-tubularized incised plate (TIP) urethroplasty for hypospadias repair varies.
- Current practice often involves catheterization for up to 7 days to minimize complications.
Purpose of the Study:
- To evaluate the outcomes of overnight urethral stenting in distal TIP hypospadias repair.
- To determine if shortened stenting duration impacts complication rates.
Main Methods:
- Retrospective chart review of patients undergoing TIP hypospadias repair between 2003-2008.
- Analysis focused on patients with overnight urethral stenting.
- Outcomes assessed included urethrocutaneous fistula, meatal stenosis, urethral stricture, and urinary tract infections.
Main Results:
- A total of 49 patients with overnight stenting and at least 12 months follow-up were analyzed.
- The overall urethrocutaneous fistula rate was 10.2% (5/49), with 6.7% (3/45) in primary repairs.
- No cases of meatal stenosis, urethral stricture, or urinary tract infections were observed.
Conclusions:
- Overnight urethral stenting for TIP hypospadias repair appears safe and does not significantly increase the risk of major complications.
- Primary TIP hypospadias repair patients may benefit from early catheter removal on postoperative day one.
Objectives:
The duration of urethral stenting after tubularized incised plate (TIP) urethroplasty for hypospadias varies among surgeons. Typically the catheter is left for up to 7 days with the goal of minimizing post-operative complications. We describe our experience with overnight stenting for distal TIP hypospadias repair.
Materials And Methods:
A retrospective chart review was performed on patients who underwent TIP hypospadias repair from 2003 to 2008. Patients who had their urethral catheter overnight were included in this analysis. Outcomes analyzed were the rates of: urethrocutaneous fistula, meatal stenosis, urethral stricture and urinary tract infections.
Results:
A total of 64 patients underwent outpatient TIP hypospadias repair. Forty-nine patients had overnight urethral stenting with at least 12 months follow-up and were included in the analysis. Five of the 49 patients (10.2%) developed urethrocutaneous fistula. Of these five patients, two had undergone re-do hypospadias repair. The fistula rate in primary repairs was 3/45 (6.7%). There were no incidences of meatal stenosis, urinary tract infections or urethral strictures.
Conclusion:
In our experience, overnight urethral stenting for TIP hypospadias repair does not significantly affect the rates of urethrocutaneous fistula, meatal stenosis and urinary tract infections. Patients who have had a primary TIP hypospadias repair may have their urethral catheter removed safely on post-operative day one.
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