Hypospadias repair without a bladder drainage catheter

Area of Science:

• Urology
• Pediatric Surgery

Background:

• Hypospadias repair traditionally involves complex procedures with potential complications.
• Urinary drainage management is a critical aspect of post-operative care in hypospadias surgery.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel urethral splint (silicone pleated stent) in one-stage hypospadias repair.
• To assess the feasibility of hypospadias repair without bladder drainage using the urethral splint.

Main Methods:

• A series of 44 consecutive patients underwent one-stage hypospadias repair utilizing a silicone pleated urethral splint.
• Patients' hypospadias severity varied, including subcoronal, distal, midshaft, and penoscrotal types.
• Initial patients (n=15) used a suprapubic tube; subsequent patients (n=29) were managed without bladder catheterization, with 15 undergoing outpatient procedures.

Main Results:

• All 44 patients achieved spontaneous voiding within 36 hours post-operation.
• No patient required subsequent catheterization or hospitalization.
• Two fistulas were reported in the series.
• The urethral splint facilitated neourethral drainage and accommodated post-operative edema.

Conclusions:

• The urethral splint is effective in one-stage hypospadias repair, allowing normal voiding and neourethral drainage.
• Management without bladder drainage is feasible and safe, offering benefits like reduced hospital stay and infection risk.
• The silicone pleated stent provides a reliable option for various hypospadias repairs, potentially simplifying post-operative care.