Distal hypospadias repair using the needle point bipolar cutting-coagulation forceps

Area of Science:

• Urology
• Pediatric Surgery
• Surgical Technology

Background:

• Distal hypospadias repair is a common pediatric urological procedure.
• The use of bipolar diathermy (BD) for dissection in hypospadias surgery has not been extensively studied.

Purpose of the Study:

• To evaluate the safety and efficacy of bipolar diathermy (BD) for all dissections in distal hypospadias repairs.
• To assess surgical complications and cosmetic outcomes using the hypospadias objective score (HOSE).

Main Methods:

• Retrospective review of 310 patients undergoing distal hypospadias repair over 11 years.
• Bipolar diathermy (BD) forceps used for all dissections, including skin incision and tissue separation.
• Cosmetic results assessed using the hypospadias objective score (HOSE), with a score ≥ 14 considered acceptable.

Main Results:

• Overall complication rate was 11.9%, with urethral fistula being the most common (6.1%).
• 90.6% of patients achieved an acceptable HOSE score (≥ 14).
• No postoperative bleeding or hematomas requiring intervention; no wound infections or necrosis.

Conclusions:

• Bipolar diathermy (BD) is a safe modality for distal hypospadias repair, providing excellent hemostasis and tissue plane visualization.
• The complication rate is favorable compared to literature, and cosmetic results are satisfactory.
• Further studies are needed to confirm these findings due to the retrospective nature of the study.