International Journal of Medical and Pharmaceutical Research
2025, Volume-6, Issue-3 doi: 10.5281/zenodo.15686665
Original Research Article
Comparative Study between Stent versus Non-Stented Urethroplasty for Distal Hypospadias
Published
May 23, 2025
Abstract

Background: Hypospadias is a common congenital defect of the male urethra, with distal types comprising 70–80% of cases. The standard treatment is urethroplasty, with tubularized incised plate (TIP) urethroplasty, which is widely accepted for distal variants. A key postoperative debate involves using urethral stents, which are traditionally used to aid healing and reduce complications. However, concerns about discomfort, infection, and mixed outcomes have led to growing interest in stentless repairs. Recent studies show comparable results between stented and non-stented approaches, though opinions remain divided due to variations in surgical techniques, patient factors, and outcome definitions, highlighting the need for standardized management strategies. Aim of the study: The aim of this study was to compare the surgical outcomes, complication rates, and functional and cosmetic results of stented versus non-stented urethroplasty in patients with distal hypospadias. Methods: This prospective, comparative observational study was conducted over 12 months (start to end) at the Department of Paediatric Surgery, Parkview Medical College & Hospital, Sylhet, Bangladesh from July 2023 to July 2024. Sixty male children (6 months–12 years) with distal hypospadias were randomized into two groups: Group A underwent urethroplasty with postoperative stenting, and Group B without stenting. Exclusion criteria included proximal hypospadias, reoperations, severe chordee, UTI, and significant anomalies. Surgeries employed the TIP or Only technique. Data on demographics, clinical features, complications, and outcomes were collected. Follow-ups occurred at 2 weeks interval initially for 3 months, then monthly for 1 year. Outcomes were evaluated using HOSE scores, parental satisfaction, and statistical analysis via SPSS v26.0. Result: In this study of 60 male children with distal hypospadias, patients were divided into groups of stented (Group A) and non-stented (Group B). Both groups had comparable baseline characteristics. Group A showed a longer operative time (78.4 vs. 72.6 minutes, p=0.03), a longer hospital stay (5.1 vs. 3.4 days, p<0.001), and higher pain scores (3.8 vs. 2.5, p<0.01). Early and late complication rates were slightly higher in the stented group, though not statistically significant. Both groups had high functional and cosmetic success at the six-month follow-up, with similar parental satisfaction and HOSE scores. Reoperation rates were marginally higher in Group A (6.7% vs. 3.3%). Conclusion: Non-stented urethroplasty is a safe, effective alternative for distal hypospadias repair, offering outcomes comparable to the stented approach. It provides advantages such as shorter operative time, reduced hospital stay, and less postoperative pain. Despite slightly higher complications in the stented group, differences were not statistically significant, supporting non-stented repair as favorable.

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