URINARY DIVERSION IN HYPOSPADIAS REPAIR: SUPRAPUBIC CYSTOSTOMY VERSUS TRANSURETHRAL CATHETERIZATION

Hypospadias Repair

Abstract

Objective: To compare the results of suprapubic with transurethral urinary diversion in hypospadias repair.
Data Source: Patients admitted to the Department of Urology and Renal Transplantation with distal or middle hypospadias.
Design of Study: Randomized Controlled Trials.
Setting: Department of Urology and Renal Transplantation, Quaid-I-Azam Medical College /Bahawal Victoria Hospital, Bahawalpur.
Period: From June 2010 to December 2011.
Materials and Methods: A total of sixty patients, 1 to 10 years of age with distal or middle hypospadias were included in the study. Patients with history of previous hypospadias repair were excluded. Patients were divided in two groups by using random numbers table, 30 patients in each group. Group I had suprapubic and Group II had transurethral urinary diversion. Tubularized Incised Plate urethroplasty and Mathieu’s repair were commonly used techniques. Stent was kept for 7-14 days. Patient discharged from hospital at 72 hours post-operatively with urethral catheter or suprapubic cystostomy intact. Patients were followed for subsequent outcome. Follow up was initially fortnightly and then at 1 month intervals. Minimum follow up period was 3 months and maximum 18 months for these particular patients.
Results: Only two patients of Group I had complications as compared to seven patients of Group II. Moreover, patient discomfort and voiding problems was more with group II than group I. Nursing care was easy in group I patients. Complication rate was significantly 10 where in group I as compared to group II.
Conclusion: The overall complication rate and patient discomfort were significantly lower with suprapubic urinary diversion in hypospadias repair, which also had a better cosmetic outcome.