Outcome Analysis of the Modified Mathieu Hypospadias Repair: Comparison of Stented and Unstented Repairs

Abstract

No AccessJournal of UrologyHypospadias1 Aug 1996Outcome Analysis of the Modified Mathieu Hypospadias Repair: Comparison of Stented and Unstented Repairs Samuel Hakim, Paul A. Merguerian, Ronald Rabinowitz, Linda D. Shortliffe, and Patrick H. McKenna Samuel HakimSamuel Hakim , Paul A. MerguerianPaul A. Merguerian , Ronald RabinowitzRonald Rabinowitz , Linda D. ShortliffeLinda D. Shortliffe , and Patrick H. McKennaPatrick H. McKenna View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65834-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compared surgical outcomes of stented and unstented Mathieu repairs in boys with primary distal hypospadias, and evaluated the efficacy and safety of caudal analgesia relative to other forms of analgesia (penile block and epidural analgesia). Materials and Methods: We retrospectively reviewed the records of 336 consecutive boys who underwent the modified Mathieu repair for primary distal hypospadias. A urethral stent was placed in 114 patients and nonstented repair was performed in 222. Adjunct caudal analgesia was given in 136 cases, a penile block in 158 and continuous epidural analgesia in 42. Results: None of the unstented cases had urinary retention. Analysis of surgical outcomes revealed no difference in fistula formation between patients with and without stents (2.63 versus 2.70 percent, respectively, p greater than 0.999). Overall complication rates in the stented and unstented groups were not significantly different (2.63 versus 3.60 percent, respectively, p = 0.756). The fistula rate in patients who received adjunct caudal analgesia was no different than in those who received other forms of adjunct analgesia (2.21 versus 3.0 percent, respectively, p greater than 0.999). Conclusions: These data suggest that successful Mathieu hypospadias repair is independent of the use of a stent. Caudal analgesia, a penile block and epidural analgesia provided effective postoperative pain control with no difference in complication rates. To our knowledge our report represents the largest observational study reported to date comparing stented and unstented repairs. However, because of the small number of complications in each group, a much larger study is required to determine statistically significant differences among these groups. References 1 : Traitment en un temps de I'hypospadias balanique ou juxtabalanique. J. Chir.1932; 39: 481. Google Scholar 2 : Outpatient catheterless modified Mathieu hypospadias repair. J. Urol.1987; 138: 1074. Link, Google Scholar 3 : "No stent, no diversion" Mathieu hypospadias repair. Canad. J. Surg.1993; 36: 152. Google Scholar 4 : The Mathieu operation. Is a urethral stent mandatory?. Brit. J. Urol.1993; 71: 492. Google Scholar 5 : Distal hypospadias repair without stents: is it better?. J. Urol.1994; 151: 1059. Link, Google Scholar 6 : Nuances of hypospadias. Probl. Urol.1990; 4: 705. Google Scholar 7 : Single stage hypospadias reconstruction without fistula. J. Urol.1990; 144: 520. Link, Google Scholar From the Department of Surgery, Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, Department of Urology, Division of Pediatric Urology, Stanford University Medical Center, Stanford, California, and Departments of Urology, University of Rochester Medical Center, Rochester, New York, and Naval Regional Medical Center, Portsmouth, Virginia.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMEIR D and LIVNE P (2018) IS PROPHYLACTIC ANTIMICROBIAL TREATMENT NECESSARY AFTER HYPOSPADIAS REPAIR?Journal of Urology, VOL. 171, NO. 6 Part 2, (2621-2622), Online publication date: 1-Jun-2004.MINEVICH E, PECHA B, WACKSMAN J and SHELDON C (2018) MATHIEU HYPOSPADIAS REPAIR: EXPERIENCE IN 202 PATIENTSJournal of Urology, VOL. 162, NO. 6, (2141-2143), Online publication date: 1-Dec-1999.Bukowski T and Williams C (2018) Percutaneous Intravesical Retrieval of a Misplaced Urethral Stent: New Laparoscopic InstrumentationJournal of Urology, VOL. 157, NO. 6, (2257-2257), Online publication date: 1-Jun-1997. Volume 156Issue 2SAugust 1996Page: 836-838 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Samuel Hakim More articles by this author Paul A. Merguerian More articles by this author Ronald Rabinowitz More articles by this author Linda D. Shortliffe More articles by this author Patrick H. McKenna More articles by this author Expand All Advertisement PDF downloadLoading ...