A stent-plus-irrigation protocol after adolescent hypospadias repair: a multicentre randomised controlled trial

Area of Science:

• Urology
• Pediatric Surgery
• Surgical Innovation

Background:

• Hypospadias repair in adolescents can lead to postoperative complications.
• Current management often involves urethral catheter drainage.
• Minimizing complications like fistulas and infections is crucial for successful outcomes.

Purpose of the Study:

• To compare the efficacy of a stent-plus-irrigation protocol versus standard catheter drainage.
• To evaluate the impact on overall complication rates after adolescent hypospadias repair.
• To assess secondary outcomes including urinary function and cosmetic results.

Main Methods:

• A multicentre randomized controlled trial involving 150 adolescents (Tanner Stage II-V).
• Participants were randomized to either a stent-plus-irrigation group or a catheter-drainage group.
• The stent-plus-irrigation group received a urethral stent and twice-daily saline irrigation.

Main Results:

• The stent-plus-irrigation group showed significantly lower overall complication rates (RR 0.33).
• Rates of urethral fistula (RR 0.27) and surgical site infection (SSI) (RR 0.43) were notably reduced.
• P-values for all primary outcomes were <0.05, indicating statistical significance.

Conclusions:

• A postoperative stent-plus-irrigation protocol effectively lowers complication rates after adolescent hypospadias repair.
• This protocol demonstrated particular efficacy in reducing urethral fistula and SSI.
• The study could not isolate the independent effect of irrigation due to the combined intervention.