Abstract
Purpose: This study aimed to evaluate the impact of glanular fixation suture on surgical outcomes in children undergoing distal hypospadias repair.
Materials and methods: We retrospectively reviewed the data of 322 patients who underwent distal hypospadias repair in our clinic between January 2014 and December 2023. Patients operated on after January 2019, when the glanular fixation technique was adopted, formed the study group; those operated on before this date constituted the control group. All procedures were performed using the TIPU (tubularized incised plate urethroplasty) technique by the same pediatric urology team. Preoperative Glans-Meatus-Shaft (GMS) scores and six-month postoperative HOSE scores were used for comparison.
Results: There was no statistically significant difference between the two groups regarding HOSE scores, fistula formation, or wound dehiscence (p>0.05). However, unintentional early dressing removal was significantly lower in the study group (2.4%) compared to the control group (11.4%) (p=0.02).
Conclusion: While the application of a glanular fixation suture did not significantly affect overall surgical outcomes in distal hypospadias repair, it was associated with improved postoperative dressing adherence. This technique may offer an advantage in clinical protocols where dressing stability is crucial for optimal wound healing. Further prospective, randomized studies are needed to validate these findings.
References
- Snodgrass WT. Consultation with the specialist: hypospadias. Pediatr Rev. 2004;25(2):63-67. doi:10.1542/pir.25-2-63
- McLorie G, Joyner B, Herz D, et al. A prospective randomized clinical trial to evaluate methods of postoperative care of hypospadias. J Urol. 2001;165(5):1669-1672.
- Steven L, Cherian A, Yankovic F, Mathur A, Kulkarni M, Cuckow P. Current practice in paediatric hypospadias surgery; a specialist survey. J Pediatr Urol. 2013;9(6 Pt B):1126-1130. doi:10.1016/j.jpurol.2013.04.008
- Merriman LS, Arlen AM, Broecker BH, Smith EA, Kirsch AJ, Elmore JM. The GMS hypospadias score: assessment of inter-observer reliability and correlation with post-operative complications. J Pediatr Urol. 2013;9(6 Pt A):707-712. doi:10.1016/j.jpurol.2013.04.006
- Arlen AM, Kirsch AJ, Leong T, Broecker BH, Smith EA, Elmore JM. Further analysis of the Glans-Urethral Meatus-Shaft (GMS) hypospadias score: correlation with postoperative complications. J Pediatr Urol. 2015;11(2):71.e1-71.e715. doi:10.1016/j.jpurol.2014.11.015
- Holland AJ, Smith GH, Ross FI, Cass DT. HOSE: an objective scoring system for evaluating the results of hypospadias surgery. BJU Int. 2001;88(3):255-258. doi:10.1046/j.1464-410x.2001.02280.x
- Martins AG, Lima SV, Araújo LA, Vilar Fde O, Cavalcante NT. A wet dressing for hypospadias surgery. Int Braz J Urol. 2013;39(3):408-413. doi:10.1590/S1677-5538.IBJU.2013.03.15
- Bush NC, Villanueva C, Snodgrass W. Glans size is an independent risk factor for urethroplasty complications after hypospadias repair. J Pediatr Urol. 2015;11(6):355.e1-355.e3555. doi:10.1016/j.jpurol.2015.05.029
- Atan A, Aykaç A, Baran Ö, Sunay M. Fixation of the glans penis and urethral catheter to the abdominal skin to avoid wound dehiscence after a hypospadias surgery: A comparative study. Turk J Urol. 2019;45(Supp. 1):S104-S107. Published 2019 Feb 20. doi:10.5152/tud.2019.65789
- Snodgrass W, Bush N. Primary hypospadias repair techniques: A review of the evidence. Urol Ann. 2016;8(4):403-408. doi:10.4103/0974-7796.192097
- Gupta A, Gupta R, Srivastav P, Gupta A. Comparison of interrupted- and continuous-suture urethroplasty in tubularised incised-plate hypospadias repair: A prospective study. Arab J Urol. 2017;15(4):312-318. Published 2017 Nov 16. doi:10.1016/j.aju.2017.10.004
- Snodgrass W, Macedo A, Hoebeke P, Mouriquand PD. Hypospadias dilemmas: a round table. J Pediatr Urol. 2011;7(2):145-157. doi:10.1016/j.jpurol.2010.11.009
- Van Savage JG, Palanca LG, Slaughenhoupt BL. A prospective randomized trial of dressings versus no dressings for hypospadias repair. J Urol. 2000;164(3 Pt 2):981-983. doi:10.1097/00005392-200009020-00015
- Narci A, Embleton DB, Boyaci EO, Mingir S, Cetinkurşun S. A practical offer for hypospadias dressing: Allevyn®. Afr J Paediatr Surg. 2011;8(3):272-274. doi:10.4103/0189-6725.91658
- Hadidi AT, Abdaal N, Kaddah S. Hypospadias repair: is dressing important. Kasr El Aini J Surg. 2003;4(1):37-44.
Distal hipospadias onarımı yapılan hastalarda penise konulan fiksasyon sütürü ameliyat başarısını etkiler mi?
Abstract
Amaç: Bu çalışmanın amacı, distal hipospadias onarımı yapılan çocuk hastalarda glansa uygulanan fiksasyon sütürünün cerrahi başarı ve komplikasyon oranları üzerindeki etkisini değerlendirmektir.
Gereç ve yöntem: Ocak 2014 ile Aralık 2023 tarihleri arasında kliniğimizde distal hipospadias onarımı yapılan 322 hastanın verileri retrospektif olarak incelendi. Ocak 2019 sonrası opere edilen ve glanüler fiksasyon sütürü uygulanan hastalar çalışma grubunu, öncesinde opere edilen ve fiksasyon yapılmayan hastalar kontrol grubunu oluşturdu. Tüm hastalar aynı cerrahi ekip tarafından TIPU (tubularized incised plate urethroplasty) tekniği ile opere edildi. Glans-meatus-shaft (GMS) skoru ve HOSE değerlendirmesi kullanılarak gruplar karşılaştırıldı.
Bulgular: İki grup arasında HOSE skorları, fistül, dehisens ve diğer cerrahi komplikasyon oranları açısından anlamlı fark saptanmadı (p>0.05). Ancak plansız erken pansuman çıkması çalışma grubunda anlamlı şekilde daha az gözlendi (p=0.02).
Sonuç: Glansa uygulanan fiksasyon sütürü, distal hipospadias cerrahisinde genel başarı oranlarını etkilememekle birlikte, postoperatif dönemde pansumanın stabilitesini artırarak iyileşmeyi dolaylı yoldan destekleyebilir. Bu teknik, pansuman bütünlüğünün önemli olduğu klinik protokollerde yararlı olabilir. Bulguların doğrulanması için ileriye dönük randomize çalışmalara ihtiyaç vardır.
References
- Snodgrass WT. Consultation with the specialist: hypospadias. Pediatr Rev. 2004;25(2):63-67. doi:10.1542/pir.25-2-63
- McLorie G, Joyner B, Herz D, et al. A prospective randomized clinical trial to evaluate methods of postoperative care of hypospadias. J Urol. 2001;165(5):1669-1672.
- Steven L, Cherian A, Yankovic F, Mathur A, Kulkarni M, Cuckow P. Current practice in paediatric hypospadias surgery; a specialist survey. J Pediatr Urol. 2013;9(6 Pt B):1126-1130. doi:10.1016/j.jpurol.2013.04.008
- Merriman LS, Arlen AM, Broecker BH, Smith EA, Kirsch AJ, Elmore JM. The GMS hypospadias score: assessment of inter-observer reliability and correlation with post-operative complications. J Pediatr Urol. 2013;9(6 Pt A):707-712. doi:10.1016/j.jpurol.2013.04.006
- Arlen AM, Kirsch AJ, Leong T, Broecker BH, Smith EA, Elmore JM. Further analysis of the Glans-Urethral Meatus-Shaft (GMS) hypospadias score: correlation with postoperative complications. J Pediatr Urol. 2015;11(2):71.e1-71.e715. doi:10.1016/j.jpurol.2014.11.015
- Holland AJ, Smith GH, Ross FI, Cass DT. HOSE: an objective scoring system for evaluating the results of hypospadias surgery. BJU Int. 2001;88(3):255-258. doi:10.1046/j.1464-410x.2001.02280.x
- Martins AG, Lima SV, Araújo LA, Vilar Fde O, Cavalcante NT. A wet dressing for hypospadias surgery. Int Braz J Urol. 2013;39(3):408-413. doi:10.1590/S1677-5538.IBJU.2013.03.15
- Bush NC, Villanueva C, Snodgrass W. Glans size is an independent risk factor for urethroplasty complications after hypospadias repair. J Pediatr Urol. 2015;11(6):355.e1-355.e3555. doi:10.1016/j.jpurol.2015.05.029
- Atan A, Aykaç A, Baran Ö, Sunay M. Fixation of the glans penis and urethral catheter to the abdominal skin to avoid wound dehiscence after a hypospadias surgery: A comparative study. Turk J Urol. 2019;45(Supp. 1):S104-S107. Published 2019 Feb 20. doi:10.5152/tud.2019.65789
- Snodgrass W, Bush N. Primary hypospadias repair techniques: A review of the evidence. Urol Ann. 2016;8(4):403-408. doi:10.4103/0974-7796.192097
- Gupta A, Gupta R, Srivastav P, Gupta A. Comparison of interrupted- and continuous-suture urethroplasty in tubularised incised-plate hypospadias repair: A prospective study. Arab J Urol. 2017;15(4):312-318. Published 2017 Nov 16. doi:10.1016/j.aju.2017.10.004
- Snodgrass W, Macedo A, Hoebeke P, Mouriquand PD. Hypospadias dilemmas: a round table. J Pediatr Urol. 2011;7(2):145-157. doi:10.1016/j.jpurol.2010.11.009
- Van Savage JG, Palanca LG, Slaughenhoupt BL. A prospective randomized trial of dressings versus no dressings for hypospadias repair. J Urol. 2000;164(3 Pt 2):981-983. doi:10.1097/00005392-200009020-00015
- Narci A, Embleton DB, Boyaci EO, Mingir S, Cetinkurşun S. A practical offer for hypospadias dressing: Allevyn®. Afr J Paediatr Surg. 2011;8(3):272-274. doi:10.4103/0189-6725.91658
- Hadidi AT, Abdaal N, Kaddah S. Hypospadias repair: is dressing important. Kasr El Aini J Surg. 2003;4(1):37-44.
Details
| Primary Language | English |
|---|---|
| Subjects | Urology |
| Journal Section | Research Article |
| Authors | |
| Early Pub Date | July 11, 2025 |
| Publication Date | |
| Submission Date | May 26, 2025 |
| Acceptance Date | July 11, 2025 |
| Published in Issue | Year 2025 Volume: 18 Issue: 4 |
