OUTCOME ANALYSIS OF THE MODIFIED MATHIEU HYPOSPADIAS REPAIR - COMPARISON OF STENTED AND UNSTENTED REPAIRS

Purpose: We compared surgical outcomes of stented and unstented Mathie u repairs in boys with primary distal hypospadias, and evaluated the e fficacy and safety of caudal analgesia relative to other forms of anal gesia (penile block and epidural analgesia). Materials and Methods: We retrospectively reviewed the records of 336 consecutive boys who unde rwent the modified Mathieu repair for primary distal hypospadias. a ur ethral stent was placed in 114 patients and nonstented repair was perf ormed in 222, Adjunct caudal analgesia was given in 136 cases, a penil e block in 158 and continuous-epidural analgesia in 42. Results: None of the unstented cases had urinary retention. Analysis of surgical out comes revealed no difference in fistula formation between patients wit h and without stents (2.63 versus 2.70%, respectively, p > 0.999). Ove rall complication rates in the stented and unstented groups were not s ignificantly different (2.63 versus 3.60%, respectively, p = 0.756). T he fistula rate in patients who received adjunct caudal analgesia was no different than in those who received other forms of adjunct analges ia (2.21 versus 3.0%, respectively, p > 0.999). Conclusions: These dat a suggest that successful Mathieu hypospadias repair is independent of the use of a stent. Caudal analgesia, a penile block and epidural ana lgesia provided effective postoperative pain control with no differenc e in complication rates, To our knowledge our report represents the la rgest observational study reported to date comparing stented and unste nted repairs, However, because of the small number of complications in each group, a much larger study is required to determine statisticall y significant differences among these groups.