Year : 2005 | Volume
: 21 | Issue : 2 | Page : 129--130
Stenting the urethra after Snodgrass repair for distal hypospadias - is it necessary?
J Chandra Singh, Nitin S Kekre
Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
J Chandra Singh
Department of Urology, Christian Medical College,Vellore – 632 004, Tamilnadu
|How to cite this article:|
Chandra Singh J, Kekre NS. Stenting the urethra after Snodgrass repair for distal hypospadias - is it necessary?.Indian J Urol 2005;21:129-130
|How to cite this URL:|
Chandra Singh J, Kekre NS. Stenting the urethra after Snodgrass repair for distal hypospadias - is it necessary?. Indian J Urol [serial online] 2005 [cited 2020 Jul 13 ];21:129-130
Available from: http://www.indianjurol.com/text.asp?2005/21/2/129/19642
Tubularized incised plate repair of distal hypospadias in toilet-trained children: should a stent be left?BJU Int. 2003;92:1003-5. El- Sherbiny MT.
This prospective randomized study was designed to evaluate the role of stenting in toilet-trained boys undergoing tubularized incised plate (TIP) repair of distal hypospadias. The study group comprises of 64 toilet trained boys who underwent TIP repair for distal penile hypospadias. All the operations were performed by a single surgeon between March and November 2001. The median age was 6 years (range 2-17 years). Patients were randomized into two groups at the end of the surgery. 29 were not stented and 35 were stented. In the stented group, a soft plastic catheter was placed in the bladder, anchored to the glans. Adjunctive penile block with 0.25% bupivacaine and acetaminophen suppositories were used for post-operative analgesia. Five and seven boys in the unstented group developed urinary extravasation and urinary retention respectively but none in the stented group developed either of these complications. 13 (45%) of the stented boys developed dysuria as compared to 5(14%) in the stented group (P P <0.001).
A multicentric retrospective study on 336 hypospadias repaired by Mathieu technique concluded that urethral catheterization did not affect the results. In another single-institution experience with 201 Mathieu hypospadias repairs, outcome of stented patients compared favorably with unstented patients. Another retrospective review of 162 hypospadias repairs without a stent published after this report documented only minimal complications and the authors have concluded that urethral stent did not make any difference. Additional reconstruction using foreskin was used in 84%.
In El-Sherbiny's study, factors that are unclear include the basis of sample size determination, method of randomization and the reason why the numbers in the two groups are dissimilar. All the other series of hypospadias repair that have claimed comparable or superior outcome with a stentless repair have used some form of skin substitution. In a recent description of the procedure by Snodgrass himself he has recommended stent placement for about a week. Hence it is advisable to place urethral stent for pure Snodgrass repair till conclusive prospective evidence is available proving that stents can be avoided.
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