Is a urethral stent necessary after tubularized incised-plate urethroplasty for primary distal hypospadias repair: Initial experience?

Background<br /> Distal hypospadias can be treated successfully with Snodgrass [tubularized incised-plate urethroplasty (TIPU)] urethroplasty usually with a postoperative urethral stent for about 7 days. However, these stents have their morbidity and complications. Previous researches negated the negative impact of early stent removal on TIPU outcomes. In this study, we tried to determine the safety of distal penile hypospadias repair using nonstented TIPU.<br /> Patients and methods<br /> A prospective case study included a total of 30 children aged between 6 and 72 months with primary distal hypospadias. They were managed by standard TIPU by the same surgeon with no urethral stent. The incidence of urine retention, meatal stenosis, and urethrocutaneous fistula were used as primary outcomes, while secondary outcomes included operative time and hospital stay along with other complications.<br /> Results<br /> Mean age was 21.7 months. Surgical-site infection was encountered in one case, acute urine retention was in two cases, meatal stenosis in two cases, and fistula in two cases.<br /> Conclusion<br /> Despite the limited number of cases, it appears that the absence of a stent in TIPU procedure does not have a significant negative impact on the postprocedural outcomes. Although nonstented TIPU is associated with prolonged hospitalization, it is associated with a significant decrease in postoperative pain with no risks of stent-related complications. Acute urine retention was a possible complication after nonstented TIPU. However, it can be reduced by applying light dressing while the stent is in place and removing it after completion of the dressing with proper analgesia.