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Postoperative care in hypospadias. Common practices and evidence available
S Fuentes Carretero1, C Grande Moreillo2, N Vicente Sánchez3
1Pediatric Surgery Unit. Hospital Universitari Mútua de Terrassa. Terrassa (Barcelona).
Insights
Pediatric surgeons commonly use probes and double diapers for hypospadias surgery postoperative care. However, practices vary regarding antibiotic use and early discharge, with evidence favoring limited antibiotics and early patient release.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- Postoperative care in hypospadias surgery presents numerous options.
- Assessing current practices and available evidence is crucial for pediatric surgeons.
Purpose of the Study:
- To evaluate the current postoperative care landscape for hypospadias surgery.
- To review existing evidence for pediatric surgeons performing this procedure.
Main Methods:
- A survey on hypospadias postoperative care was distributed to pediatric surgeons.
- A review of published evidence on the topic was conducted.
Main Results:
- 46 surgeons responded; 100% use a probe/stent, 87.8% use double diapers.
- Most remove probes after 5-7 days; 65.2% allow early discharge.
- Antibiotic prophylaxis varies: 60.9% use it with the probe, 34.8% use full-dose therapy.
Conclusions:
- Consensus exists on urethroplasty guidance and compression dressings.
- Discrepancies noted in antibiotic use and early discharge protocols.
- Evidence suggests probe, double diaper, early discharge, and limited antibiotics; individual patient experience may guide choices.
Introduction:
There are many alternatives available regarding postoperative care in hypospadias surgery. The objective of this study was to assess the current care situation in our environment and to review the evidence available for pediatric surgeons who conduct this procedure.
Materials And Methods:
A survey regarding the main aspects of hypospadias postoperative care was created and distributed to pediatric surgeons. In addition, the evidence currently published in this field was reviewed.
Results:
A total of 46 replies were achieved. 100% of the surgeons leave in place a probe or stent, and more than 80% remove it after 5 or 7 days. 87.8% of the respondents use a double diaper, but only 65.2% discharge patients early in the postoperative period. 60.9% prescribe antibiotic prophylaxis for as long as the probe remains in place, and 34.8% use full-dose antibiotic therapy.
Discussion:
There was a general consensus regarding urethroplasty guiding and the use of compression dressings among the pediatric surgeons surveyed. However, more discrepancies were found in the use of antibiotic therapy and early discharge. The currently available evidence and international practice suggest using a probe with double diaper and early discharge, with postoperative antibiotics being limited. In the absence of clear evidence for a specific care type, the patient's experience could be used to choose the best postoperative protocol on an individual basis.
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