[One-stage nonstented tubularized incised plate urethroplasty for pain and complication after hypospadias repair].

OBJECTIVE

To comparatively analyze the effect of one-stage nonstented tubularized incised plate urethroplasty (TIP) on operative pain and complication by comparing with urethral catheter and urethral stent drainages.

METHODS

Between March 2010 and June 2013, 214 cases of distal and mid-shaft hypospadias underwent TIP, and the clinical data were analyzed retrospectively. The patients were divided into 3 groups based on different urinary drainage techniques: indwelling urethral catheter was used in 68 cases (group A), indwelling urethral stent in 70 cases (group B), and nonstented drainage in 76 cases (group C). There was no significant difference in age, hypospadias type, and accompany malformation among 3 groups (P > 0.05). At 2 days after operation, Wong-Banker facial scale (WBS) and Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) were used for pain and praxiology assessment. The complications after operation also were observed and compared among 3 groups.

RESULTS

All patients were followed up 6-25 months (median, 11.8 months). At 2 days after operation, the median WBS scores were 4.0 (0-10), 3.5 (0-10), and 3.0 (0-10) in groups A, B, and C, respectively; median CHEOPS pain scores were 6.0 (1-13), 6.0 (1-13), and 4.0 (1-11), respectively. The WBS pain score and CHEOPS pain score in group C were significantly lower than those in groups A and B (P < 0.05), but there was no significant difference between group A and group B (P > 0.05). The postoperative complication occurred in 27 cases (39.7%) of group A, 29 cases (41.4%) of group B, and 13 cases (17.1%) of group C; two or more than two complications occurred in 14, 15, and 9 cases, respectively. There was significant difference in total incidence of postoperative complication among 3 groups (P < 0.05). The incidences of postoperative overactive bladder, bladder spasms, urinary tract infection, and fistula in group C were significantly lower than those in groups A and B (P < 0.05). There was no significant difference in incision infection, acute urinary retention, urinary extravasation, meatal stenosis, and urethral stricture among 3 groups (P > 0.05).

CONCLUSION

One-stage nonstented TIP is suitable for distal and mid-shaft hypospadias and could reduce postoperative pain and complications compared with the traditional postoperative indwelling urethral catheter and indwelling urethral stent.