Dribbling diversion in Y-V glanuloplasty modified Mathieu repair.
BACKGROUND
Aim of the study was to determine the impact of an indwelling transurethral catheter on surgical outcome and postoperative micturation in Y-V glanuloplasty modified Mathieu repair for primary hypospadias.


METHODS
Fifty-nine consecutive boys underwent Y-V glanuloplasty modified Mathieu repair for primary distal hypospadias in our institution. The first 37 patients (group A) had catheterless repair. Due to significant painful postoperative urination, the next 22 children (group B) had an indwelling transurethral catheter (5 Fr feeding tube) for 24-48 hours. Adjunct caudal analgesia and penile block was given in both groups. Pain during postoperative voiding, urinary retention, meatal stenosis and fistula formation was statistically analysed with Wilcoxon's signed rank test.


RESULTS
All patients in group A had distressing painful first micturation (p < 0.05). Eight children did not pass urine for more than 8 hours. Five (13.5 %) patients had urinary retention, 3 of whom required catheterisation (p < 0.05). Six (16 %) boys developed meatal stenosis and a further 5 (13.5 %) had urethrocutaneous fistula. In group B all patients had easy micturation after removal of the catheter. Only 1 boy developed a urethrocutaneous fistula and none of the boys in this group presented with meatal stenosis.


CONCLUSIONS
An indwelling transurethral catheter obviates urinary retention and avoids distressing postoperative micturation. It minimises the chance of urethrocutaneous fistula and meatal stenosis in Y-V glanuloplasty modified Mathieu repair.
Fathi
K
K
Surgical Unit, Paediatrics Clinic, Pécs, Hungary. khaledfathi@hotmail.com
Pintér
A
A
D000293:Adolescent; D000772:Anesthesia, Local / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000209:etiology / Q000517:prevention & control; D017577:Cutaneous Fistula / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014521:Urethra / Q000473:pathology; D014546:Urinary Catheterization; D014548:Urinary Fistula / Q000209:etiology / Q000517:prevention & control; D013521:Urologic Surgical Procedures, Male / Q000379:methods*