Mathieu repair in distal penile hypospadias with or without stent
Keywords:Hypospadias. Urethra. Stent. Penis. Surgical Flaps. Reconstructive Surgical Procedures. Penile Diseases. Follow-Up Studies. Endocrine System Diseases.
Objective: To compare the outcome of two techniques for repair of distal penile hypospadias: Mathieu`s repair with and without stent. Study Design: Prospective observational descriptive study. Place and duration: Department of Paediatric Surgery, Mayo Hospital, Lahore from September 2000 to September 2002. Material and methods: Sixty boys were randomly assigned the two groups of thirty boys each. Detailed scrutiny of procedure done and analyses of the clinical outcome made prospectively. Results: A total of sixty patients were treated in two separate groups. All the boys had Mathieu`s repair done for distal hypospadias. In group A stent/ indwelling catheter was used for 7-8 days while in group B no stent was used. Stratification was done using Chi square test. Median age was 4 years and most of them belonged to low socioeconomic class (61.6%). A high percentage (48.3% were born to mothers of age ranging from 30-40 years. Sixteen (26.66%) patients had a family history of hypospadias. Only twelve mothers (2 0%) gave a positive history of drug intake in first trimester. Sixteen (26.66%) patients had associated anomalies of undescended testis / inguinal hernia. Twenty four (40%) patients were brought because of the abnormal appearance of the child`s penis while their stream (21.66%) and dysuria (25%) were presenting complaints of two other major groups. Mathieu`s repair was done in all cases with group A. Thirty boys (50%) having a stent post operatively and the group B thirty boys (50%) were without stent. Total complications rate is 46.66% with group a showing eight cases (26.66%) and group B having twenty (66.66%) cases with compliec. Major complication in group B was urinary retention in eleven cases (36.66%) while no patient had retention in group A. overall twenty six (86.66%) in group A and twenty one (70%) in group B showed satisfactory results. Conclusion: Mathieu`s repair without stent has been advantage of shorter hospital stay but a fair proportion of patients (36.66%) having urinary retention calls for further studies on a larger scale.
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