ONE-STAGE HYPOSPADIAS REPAIR WITH STENT OR SUPRAPUBIC DIVERSION - WHICH IS BETTER

Purpose: The authors report on 105 consecutive patients who underwent one-stage hypospadias repair based on use of suprapubic diversion or t ransurethral drainage with stenting. Methods: The surgical procedures included 52 metal-based flap urethroplasty (Mathieu) for coronal, subc oronal, and distal shaft hypospadias; 32 transverse island pedicle gra ft (Duckett) for mid and proximal shaft hypospadias; 21 transverse isl and pedicle (Duckett) plus rolled midline tube (Thierchs) for penoscro tal and scrotal hypospadias. To accomplish urinary drainage, suprapubi c diversion (cystofix) was used in 28 of 52 Mathieu operations, in 17 of 32 Duckett operations, and in 11 of 21 transverse island pedicle gr aft plus rolled midline tube operations. In the rest of the cases, tra nsurethral drainage with stenting was used. Results: All children had excellent cosmetic and functional outcomes. But the rates of complicat ions such as fistula and meatal stenosis were significantly different between the groups in which suprapubic tube or urethral stent was used . In 56 of the 105 patients in whom suprapubic diversion was used, fou r (7.14%) had fistulas and three (5.35%) had meatal stenosis, in contr ast to a fistula rate of 14.28% and meatal stenosis rate of 12.24% in patients that urethral stent is used for urinary drainage. Conclusion: The authors believe that the use of suprapubic diversion is advantage ous for the outcome of one-stage hypospadias repair in relation to fis tula occurrence and meatal stenosis.