Stentless hypospadias repair: The way forward

Abstract

Background: Stentless repair of hypospadias has been previously described in the literature for distal penile hypospadias repair. This was a prospective non-randomized study with the aim of assessing the efficacy of stentless repair in our health-care system. Methods: A total of 104 patients managed prospectively for hypospadias over a 30-month period who met the inclusion criteria were included in the study and underwent a stentless modified tubularized incised plate (TIP) urethroplasty repair (with a slight modification described subsequently) by three surgeons and were followed up for a minimum period of six months. Results: The median age at surgery was eight months. The site of meatus was glanular in 20 patients, coronal in 36 patients, sub-coronal in 38 patients and mid-penile in 10 patients. The median operative time was 47 minutes (range 32–76 minutes). The median time to first micturition was 140 minutes (range 10–300 minutes). Voiding difficulty was encountered in two patients, requiring catheterization. Three patients had superficial surgical site infections which were conservatively managed. All patients were discharged on the second postoperative day, except for the three patients with surgical site infection. On follow-up, two patients had a fistula. Conclusion: Stentless repair of hypospadias is the future and the new standard of care and should be used in every case where a modified TIP repair is feasible. This decreases complications from urethral stenting and decreases the duration of hospital stay. Both patient and parents are comfortable with this procedure. Level of evidence Level 2.