Foreskin healing after distal hypospadias repair: Does stenting affect the outcome?

Background: Distal penile hypospadias account for about 70% of all cases of hypospadias. There is a variety of operative techniques that could be performed when foreskin reconstruction is an option. The urethral stent is left in the urethra to prevent complications.

Objectives: To determine whether the duration of stenting influences the healing of foreskin after distal hypospadias repair.

Material And Methods: Data from 2 institutions was retrospectively analyzed. Inclusion criteria were as follows: 1) a modified meatal advancement glanuloplasty without tubularization of the urethral plate, 2) foreskin reconstruction and 3) follow-up - 12 months. All other types of reconstruction and re-do procedures were excluded. The period of urethral stenting was determined intraoperatively depending on the surgeon's preferences. Mean age at operation was 23.3 months. The cohort was divided into 3 groups. In Group I (G-I), no catheter was left or it was removed the next day after surgery. In Group II, the catheter was left for more than 5 days. In those 2 groups, the surgery was done by different surgeons. Group III consisted of 35 patients who had a stent for <2 days, and the procedure was performed by the same surgeon. The χ2 with Yates's correction and Pearson's χ2 tests were used for the statistical analysis.

Results: Overall, 11 patients had foreskin dehiscence and needed re-do surgery. None of the patients required operation because of foreskin stenosis. Complications occurred in 3 out of 33 patients (9%) in Group I, 2 out of 27 in Group II (7.4%) and 6 out of 35 in Group III (17%). There was no statistically significant difference between Groups I and II (p = 0.8144), nor between Groups I and III (p = 0.5344). In the non-parametric Pearson's χ2 test, no significant difference was found in such grouped data (p = 0.4239).

Conclusions: Prolonged urethral stenting does not reduce the risk of a re-do foreskin surgery after hypospadias repair.