Replacing a smaller-size catheter after tubularized incised plate urethroplasty may decrease postoperative urethral complications

Abstract

Objective To investigate the effect of replacing a smaller-size catheter after tubularized incised plate (TIP) urethroplasty on postoperative urethral complications. Methods The data of 116 hypospadias patients underwent TIP urethroplasty performed by the same urologist in our hospital from January 2014 to December 2017 were retrospectively analyzed. The age of patients ranged from 0.5-15.4 years, with the median age of 1.5 years. Meatal location was distal in 47(39.5%), midshaft in 62(52.1%) and proximal in 10(8.4%) patients. Unhealthy urethral plate occurred in 49(42.2%) patients. F8 catheter was used for urethroplasty in 92(79.3%) patients, F10 in 17(14.7%), and F12 in 7(6.0%). According to the pattern of urinary diversion, patients were divided into two groups. Conventional catheter group in 56 patients (group A): the catheter was chosen in as large size as possible for urethroplasty without tension. Replace a smaller-size catheter group in 60 patients (group B): replace a smaller-size catheter after urethroplasty on the basis of group A. There were no statistically significant differences in age, meatal location and catheter size between the two groups (P>0.05). Results The mean follow up was 23 months (range 6-66 months). There were 73(62.9%) cases of orifice overflow during indwelling catheterization. There were 5(4.3%) patients needed further reoperation result from postoperative urethral complications, including 4 cases of fistula and 1 case of meatal stenosis. The process of replacing a smaller-size catheter after urethroplasty in group B was simple and without adverse reactions. There were 15(26.8%) cases of orifice overflow in group A and 58(96.7%) in group B. There were statistically significant differences in orifice overflow between the two groups (P<0.05). There were 5(8.9%) cases of postoperative urethral complications in group A and 0 case in group B. There were statistically significant differences in postoperative urethral complications (P<0.05). Conclusions The process of replacing a smaller-size catheter after TIP urethroplasty in was simple and subsequently contributed to less postoperative urethral complications. The results of replacing a smaller-size catheter after TIP urethroplasty were superior to that of no replacing conventionally. Key words: Hypospadias; Tubularized incised plate urethroplasty; Catheter; Urethral complications