Comparative Study between Early and Delayed Removal of Urethral Stent after Tubularised Incised Plate Urethroplasty in Distal Hypospadias

Abstract Background: The use of urethral stent is very popular in hypospadias repair in order to permit the repair to be water tight, immobilize the suture line, tamponade any hemorrhage and avoid the risk of urinary retention. However, some pediatric surgeons don’t prefer to leave urethral stents for long time, and remove it early to avoid complications such as inflicting pain, bladder spasm and infection. Aim of Study: This study aimed to compare the early and delayed removal of urethral stent in the repair of distal hypo-spadias regarding hospital stay and the incidence of postopera-tive complications. Patients and Methods: This is a prospective randomized controlled study performed from May 2019 to January 2022. It included 42 patients with distal hypospadias repaired by the tubularizd incised plate technique. They were divided randomly into 2 groups; where the urethral catheters were assessed for early removal after 48 hours in group A, and they were removed on the 5th postoperative day in group B. Both groups were com-pared regarding the hospital stay and the incidence of postoper-ative complications. Results: Early removal of the urethral stent was feasible in 84% of cases, whereas it was delayed to the 5th postopera-tive day because of oedema in 3 cases and hematoma in 1 case. Postoperative hospital stay was significantly shorter in group A cases with a mean of 3.74 days versus 5.86 days in group B (p-value <0.001). Postoperative complications were compa-rable in both groups with overall complications rate of 28.6% and 23.8% in group A and B respectively (p=0.726). Fistula and glans dehiscence were the commonest postoperative com-plications; fistula was reported in 2 cases in group A and 3 cases in group B, while glans dehiscence was reported in 2 cases in group A versus a single case in group B. There were no sta-tistically significant differences between both groups regarding each type of complications (p>0.05). Conclusion: Early removal of urethral stent after repair of distal hypospadias is applicable in the majority of cases with significantly shorter hospital stay and without increase in the incidence of postoperative complications.