Suprapubic Diversion Research Articles

Temporal suprapubic diversion with ureteral catheter in a premature patient

Temporal suprapubic diversion with ureteral catheter in a premature patient

Outcomes of early endoscopic realignment for blunt straddle injuries to the bulbar urethra: a single-center retrospective study

BackgroundThe optimal acute management of patients with blunt straddle injury to the bulbar urethra remains in question. Conventionally, suprapubic diversion with delayed urethroplasty can always be considered, if necessary, but the role of early endoscopic realignment (EER) in the acute management of blunt straddle injuries to bulbar urethra is controversial. We report our clinical experience and outcomes with EER for patients with straddle injury to the bulbar urethra in a level one trauma center.MethodsWe retrospectively reviewed 44 male patients who were transferred to our trauma center between January 2013 and January 2019 for acute management of blunt straddle injury to the perineum leading to bulbar urethra injuries. We reviewed the medical records of those patients to identify demographics, emergency management and clinical outcomes.ResultsThe most common injury mechanism was falling onto the perineum (n = 27, 61.4%), followed by motorcycle accident (n = 11, 25.0%) and bicycle accident (n = 6, 13.6%). Of the 44 patients, 14 (31.8%) were partial bulbar urethral ruptures and 30 (68.2%) were complete bulbar urethral ruptures. 31 (70.5%) patients successfully underwent EER and 13 (29.5%) patients failed attempted EER. the difference between successful EER attempts and failed ones in term of injured urethral mucosa integrity was statistically significant (P = 0.035, OR 8.667,95% CI: 0.998–75.235). In patients who underwent successful EER, urethral stricture occurred after catheter removal at a median of 8 (1–28) months in 24 (77.4%) patients and the mean stricture length was 1.8 ± 0.8 (0.5–3.0), which was not statistically significant when compared with those who failed EER (P = 0.103). Overall, 21 out of 24 (87.5%) patients with strictures after EER were successfully managed by urethroplasty.ConclusionsAlthough achieving a successful EER attempt is relatively easy for most patients with straddle injury to the bulbar urethra, it does not improve urethral healing significantly. Most patients with stricture formation after EER have to be cured with urethroplasty.

The Comparison on Complications from Suprapubic vs. Transurethral Urinary Diversion After Hypospadias Repair: Meta-Analysis

Background: Urinary diversion post hypospadias repair plays an important role in the prevention of complications. This study objective was to analyze the comparison among suprapubic versus transurethral urinary diversion in preventing the complications after hypospadias repair. We aimed to compare the complications from suprapubic urinary diversion and transurethral urinary diversion in patients after hypospadias repair. Methods: A systematic search was conducted in PUBMED and Google Scholar databases to identify relevant randomized controlled trials (RCTs). The subjects were studies that involved post-operative hypospadias patients. Compared outcomes were the incidence of urethrocutaneous fistula, meatal stenosis, and repair disruption. The approach to systematic study began with the use of PRISMA protocol based on inclusion and exclusion criteria. Meta-analysis was performed based on pooled analysis. Visualizations of each study were described with forest plots. Results: There were two RCTs that met the criteria for quantitative analysis. Forest plot analysis showed the use of suprapubic diversion might significantly lower the risk of urethrocutaneous fistula (OR 0.22, 95% CI 0.05 - 0.89, p = 0.03). Meatal stenosis and repair disruption between the two studies did not differ significantly. Conclusion: There was a significantly lower incidence of urethrocutaneous fistula in postoperative hypospadias patients who performed suprapubic urine diversion compared to those who received transurethral urine diversion. The difference in the incidence of meatal stenosis and repair disruption was insignificant between the two groups of urine diversion.

Catheter-induced urethral injury and tubularized urethral plate urethroplasty in such iatrogenic hypospadias

BackgroundCatheter-induced urethral erosion can involve meatus, glans and any extent of penile shaft. These injuries cause a lot of psychological, social and sexual trauma to the patient. Though the use of condom drainage system can render this spinal cord injury patient effectively dry, but can lead to penile or urethral complications. Many of these patients are kept on indwelling catheter. Long duration catheterization, poor catheter care in such paraplegic patients and other morbid patients may lead to urethral erosions. We conducted a prospective study of catheter-induced urethral injury from July 2014 to February 2016 in our tertiary care centre. The demographics, past history of illness, catheter material, and duration of catheterization, securing of catheter, local examination findings and associated comorbidities were recorded. Factors leading to urethral erosion were evaluated. And patients, who were fit and were willing for surgery, underwent tubularized urethral plate urethroplasty after 4–6-week supra-pubic diversion. The objective of the study was to evaluate factors of urethral erosion, and the results tubularized urethral plate urethroplasty in iatrogenic hypospadias.ResultsWe had twelve patients of catheter associated urethral injury in the study period. Age of the patients varied from 34 to 95 years with a mean of 61.25 years. Duration of catheterization ranged from 6 to 24 months with a mean duration 10.9 months. Catheters used were silicon coated, not secured to abdomen and had comorbid condition of neurological or cardiac origin in all patients. Long duration of catheter, poor quality of catheter and poor catheter care such moribund with poor body resistance patients were the main causative factor for urethral erosion. Urethral injuries varied from erosion of distal 2 cm to entire ventral urethra till penoscrotal junction with or without penile torque. Six of these patients underwent tubularized urethral plate urethroplasty with good cosmetic and functional postoperative outcome.ConclusionPatients of spinal cord injury, patients with comorbid condition like diabetes mellitus and ischaemic heart disease, poor catheter care and long duration catheterization are likely to have severe urethral injury. Extent of injury may vary from meatal erosion to erosion of entire ventral urethra till penoscrotal junction leading to iatrogenic hypospadias. These patients either may be put on clean intermittent catheterization or supra-pubic catheterization. Results of tubularized urethral plate urethroplasty in such iatrogenic hypospadias are very good.

Appendicular Mucosal Tube Implant with Dartos Wrap Operation for Hypospadias

Aims and Objective: To develop a better operation for hypospadias patients with poor and bad quality urethral plate and damaged urethral plate as in hypospadias cripples. Materials and Methods: I operated 21 cases of hypospadias with Appendicular mucosal tube implant with Dartos wrap operation from 17/04/2017 to 03/03/2019, in Jawale Institute of pediatric Surgery, and that group was labeled as group A. 27 cases of hypospadias were operated in same time span with conventional techniques such as extended Snodgrass operation and Byar’s two-stage operation (group B), kept as control. 7 patients (33.33%) were cases of hypospadias cripples with multiple surgeries done in the past. 4 patients (9.52%) patients had congenital short urethra. Remaining 10 patients (50%) were fresh cases with no operation done in past but with bad and fibrotic urethral plate. The longest follow up was 3 years and the shortest of 1 year. Technique of Operation: Appendicectomy performed by open technique and the serosa of Appendix cut longitudinally and stripped off the mucosal tube. The proximal hypospadias opening sutured with the appendicular mucosal tube with 6 sutures of 5-0 Vicryl. Dartos fascia is raised from the scrotum wrapped over the tube and 8 - 10 interrupted stitches taken with 5-0 Vicryl. Glanuloplasty performed over it. Suprapubic diversion did and kept for 3 weeks postoperatively. Results: In group A, 3 patients developed fistula and only 1 (4.76%) required repair at the end of 6 weeks. 2 (9.52%) patients developed grade 3 infection and settled with conservative treatment. UFR was normal at the end of 12 weeks (12.85 Ml/sec. In group B, 11 patients developed fistula and 9 (33.33%) required repaired. 9 (33.33%) patients developed strictures and all of them required multiple urethral dilatation under GA. 7 (25.92%) patients developed meatal stenosis.UFR was badly reduced with average of 5.78 ML/Sec. Conclusion: The operation proves to be a much better option compared to the conventional for group A patients. We need a series with longer follow up and larger number of patients.

Effect Of Intraoperative Cystofix Device on Postoperative Complications In Distal Hypospadias Cases

Objective: To investigate the effect of suprapubic diversion on postoperative complications in distal hypospadias repair performed with tubularized incised plate urethroplasty (TIPU). Materials and Methods: Twenty-three patients with distal hypospadias who were treated with TIPU in Van Training and Research Hospital were evaluated retrospectively. Patients were divided into two groups as follows; Group I consisted only stented patients while Group II was consisted of patients with both anterior urethral stent and suprapubic diversion. Post-operative complications were documented and statistically compared thereafter. Results: Eleven patients who had only urethral stenting constituted Group I, while 12 patients with anterior urethral stent and cystofix were group II. Statistical analysis revealed less early and late post-operative complications in the suprapubic diversion group compared to only stented group. Conclusion: We think that suprapubic diversion in distal hypospadias cases treated with TIPU is a method that can be preferred in terms of less complication rates and more patient comfort than urethral stent alone.

Techniques - Temporary suprapubic diversion in a septic male infant using double-J stent: Indications and surgical technique.

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Comparative study between the usage of transurethral diversion and suprapubic cystostomy after distal hypospadias repair by tubulerized incised urethroplasty

Objective:-to compare the usage of transurethral urinary diversion and that of suprapubic cystostomy after distal shaft hypospadias repair by tubulerized incised urethroplasty.Method: - between December 2008 to October 2010 a 48 boys who had primary hypospaidais under went surgical repair by tubulerised incised urethroplasty, they divided into two groups according to the type of urinary diversion that used post operatively; group A with suprapubic diversion and group B with transurethral nasogasteric tube diversion.Result: - 48 boys aged between 3-21years with hypospadais had divided in to two equal groups according to type of post operative urinary diversion (suprapubic and transurethral), the distribution of hypospadais type similar in both groups. Urinary diversion was more effective , post operative complication were rare ,no trigon irritation and excellent cosmetic result (100%) were recorded following transurethral diversion with nasogasteric feeding tube ,conversely the creation of suprapubic cystostomy increased incidence of trigon irritation (12.5%) and fistula formation( 4.17 %).Conclusion: - transurethral urinary diversion was very effective and gave better result than suprapubic cystostomy in distal type hypospadias repair.

Cowper's syringocele: A rare differential diagnosis of infravesical obstruction in boys and young adults

Cowper's syringocele is a cystic dilation of the bulbourethral gland duct, initially defined by Maizels etal. in 1983. Although obstructive and non-obstructive types of this rare anomaly are described, clinical symptoms are highly unspecific. Therefore, we report 12 cases of children and young adults diagnosed with Cowper's syringocele to further clarify clinical course, comorbidity and treatment strategies. We retrospectively collected clinical data of 12 children and young adults from birth to 18.5 years (median 7.2 years) who had been treated in four different institutes during a period of 16 years. The primary specific diagnostic work-up consisted of ultrasound, cystourethrography, and cystoscopy. 3Older patients with a median age of 11.8 years clinically presented with obstructive voiding pattern or gross hematuria; infants with a median age of 0.6 years presented with febrile urinary tract infections (UTIs). After cystoscopic confirmation in all patients, endoscopic treatment was possible in nine; open surgical resection was necessary in three patients. Because of intrauterine megacystis and chronic renal failure, one boy underwent suprapubic diversion with a cystostomy soon after birth. Owing to urological comorbidity or later complications, additional procedures were necessary, for example, resection of minor urethral valves, prophylactic circumcision for UTI, endoscopic or open antireflux procedures, and occasionally complex bladder reconstructions in the long term. According to our data, the initial clinical symptoms of Cowper's syringocele were related to presenting age rather than the previously described type of syringocele according to Maizels etal. Infants presented with febrile UTIs; however, older boys and young adults had mainly voiding problems or nocturnal enuresis. Therefore, the clinical significance of the described syringocele types must be questioned. Eighty-three percent of our patients showed additional urological pathology such as vesicoureterorenal reflux, ureteropelvic junction obstruction, megaureter, or minor urethral valves. Thus, Cowper's syringocele hardly seems to be an isolated pathology. Although rare, Cowper's syringoceles should be considered in differential diagnosis of infravesical obstruction in boys and young adults. Diagnostics are usually justified by presenting symptoms such as UTI or urinary flow impairment, which seem to be age dependent. Despite modern diagnostic tools, diagnosis is usually made by cystourethrography and sometimes accidentally by cystoscopy. Considerable urological comorbidities and consecutive bladder dysfunction need long-term follow-up.

FRII-02 THE MANAGEMENT OF GENITOURINARY TRAUMA IN WORLD WAR II

You have accessJournal of UrologyHistory of Urology: History Forum II1 Apr 2016FRII-02 THE MANAGEMENT OF GENITOURINARY TRAUMA IN WORLD WAR II Joseph Sterbis, Ronald Caras, John Musser, and Ryan Speir Joseph SterbisJoseph Sterbis More articles by this author , Ronald CarasRonald Caras More articles by this author , John MusserJohn Musser More articles by this author , and Ryan SpeirRyan Speir More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2923AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES During the course of World War II, the United States lost over 400,000 service members, with more than 600,000 wounded. Genitourinary injury accounted for approximately 0.5% of those wounded. Our intent is to review the injuries and treatment modalities from that time, allowing for contemporary comparison. METHODS Primary and secondary literature sources were reviewed from World War II and the post-war era. These sources were surveyed to determine the organ-specific incidences of injury, the nature of combat-related genitourinary trauma, and the surgical and medical therapies utilized in both forward and rear echelons. RESULTS Reports of organ-specific injury rates demonstrate varied incidences: Kidney: 25-40%, External Genitalia: 30-56%, Bladder: 12-15%, Ureter: 1-3%. Reports following the war that discuss treatment modalities focus on immediate control of hemorrhage, urinary drainage, and infection control. Preoperative imaging of the kidney was considered of great importance when feasible, with authors recommending a one-shot intravenous pyelogram as a minimum. Conservative management of blunt renal trauma was advocated. Renorraphy was performed when feasible in penetrating trauma. Vascular repair was also considered, though no reported cases were identified. Upper ureteral injuries were managed with early repair over a catheter, while lower injuries were reimplanted. The Davis intubated ureterotomy, first reported in 1946, was advocated as a means for management of post-traumatic stricture. Extraperitoneal bladder injuries were managed conservatively or with repair if surgery for other injuries was planned. Intraperitoneal bladder injuries were managed with repair and suprapubic cystostomy. Posterior urethral injuries were managed via suprapubic diversion and early surgical approximation, the nature of which was ill-defined. Neurogenic bladder from spinal cord injury was generally managed with suprapubic cystostomy, with authors very clear that such injuries were not to be managed with intermittent catheterization. CONCLUSIONS With this year marking the 71st anniversary of the conclusion of World War II, review of historic data provides perspective informing our contemporary combat trauma management. With the notable exception of neurogenic bladder, many management principles have been preserved over time. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e521 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Joseph Sterbis More articles by this author Ronald Caras More articles by this author John Musser More articles by this author Ryan Speir More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

A Rare Case of Synchronous Colorectal Cancer in a Patient of Attenuated Variant of Familial Adenomatous Polyposis

A total of 153 patients underwent surgical repair of hypospadias by single stage single layer urethroplasty (Yadav's Technique) over last 26 years by a single surgeon. Medium age of the patients at the time of surgery was 4.7 years (range 1 year to 12 years). Associated chordee was corrected at the same stage followed by modified Denis Browne repair along with dorsal slit to release tension over the secure line. None of the cases had suprapubic diversion of urine. A 6F or 8F infant feeding tube was kept as stent earlier for 7 to 9 and now for 5 days only.The results were cosmetically good in 123 cases, satisfactory in 21 and poor in 9 patients. Urethrocutaneous fistulae were seen in 4.5% patients, distal breakdown of repair in 1.3% whereas none of the cases had stricture or residual chordee. This simple technique can be used for all types of hypospadias with low complication rate and good functional results. Moreover being a single stage technique, it is economical and with satisfactory results.

Magnetic urethral closure device. Negative outcome after implantation for the treatment of female urinary incontinence

We report on a negative outcome after implantation of a magnetic urethral closure device, consisting of one part screwed into the pubic bone and one part as a vaginal cone, for the treatment of urinary stress incontinence gradeIII. Continence was never achieved for the patient. The urethra narrowed over time due to erosion and scarring and the patient started intermittent catheterization, because spontaneous micturition was not possible. The magnet was broken, the bladder neck was eroded, several fragments were found in the bladder, and numerous fragments were scattered throughout the small pelvis. Surgery consisted of removing most of the fragments, followed by bladder neck closure and suprapubic diversion.

Pro: endoscopic realignment for pelvic fracture urethral injuries.

Patients with pelvic fracture urethral distraction injuries may benefit from early endoscopic realignment. Realignment is associated with a low risk of immediate complications and has a high success rate for achieving catheter placement. Review of over thirty studies assessing for subsequent urethral stenosis, including at least a dozen that directly compare realignment to suprapubic diversion along, conclude that there is a benefit averaging at least 35% in favor of realignment. Furthermore, realignment may result in easier subsequent urethroplasty and possibly shorter stenoses.

Does the type of urinary diversion affect the result of distal hypospadias repair? A prospective randomized trial

The purpose of this review is to evaluate different techniques in urinary diversion and urethral stenting in hypospadias surgery. The surgical procedure included 192 tubularized incised plate (TIP) repairs for distal penile hypospadias. The patients were prospectively randomized into three groups: In group A, a urethral catheter was used as a stent and for diversion of urine (63 patients); in group B we use no urethral stenting (63 patients), only a suprapubic catheter; and in group C we use a suprapubic diversion and we put a small catheter in the anterior urethra only (66 patients). The urethral catheter was removed in group A at the 6th-7th postoperative day and in group C the urethral stent was removed at the 3rd-4th postoperative day. The suprapubic catheter was removed in both groups B and C at the 7th-9th postoperative day. All patients received an injection of antibiotics in the morning of the operation and daily until the day of catheter removal. All of the operations were performed by the same surgeon. The mean ages of our patients were 3, 5, and 5 years in groups A, B, and C, respectively. The mean hospital stay was 5 days (3-8). Follow-up ranged from 8 to 48 months (mean of 21.5 ± 10.1 months). Bladder spasm was observed in 33% of our patients in group A while there were no cases of spasm in the other two groups with a statistically significant difference (p < 0.05). Fistula was reported in eight patients (12.7%) of our urethral catheter group A, while it was observed in three patients (2.3%) of our suprapubic diversion groups B and C with a statistically significant difference between the two groups (p < 0.05). Meatal stenosis was reported in eight patients in group B (12.7%; nonstented group) versus three patients of both groups A and C (2.4%; stented groups) with a statistically significant difference (p < 0.05). Suprapubic diversion is an important step in hypospadias repair as it provides a better success rate with a significantly lower rate of occurrence of fistula. However, the addition of a stent in the anterior urethra to suprapubic diversion avoids the development of meatal stenosis and also avoids the bladder spasm observed with a urethral catheter.

Comparison of Immediate Primary Repair and Delayed Urethroplasty in Men with Bulbous Urethral Disruption after Blunt Straddle Injury

PurposeThe aim of this study was to analyze the outcomes of immediate primary repair (IPR) compared with delayed repair (DR) after initial suprapubic cystostomy.Materials and MethodsWe reviewed the records of 60 patients with bulbous urethral disruption after blunt trauma from February 2001 to March 2011. Seventeen patients who presented in an acute injury state underwent IPR; 43 patients underwent DR after the initial suprapubic cystostomy. None of the patients had undergone previous urethral manipulation. We compared the outcomes, including stricture, impotence, and incontinence, between the two management approaches. We also measured the time to spontaneous voiding, the duration of suprapubic diversion, and the number of days spent in the hospital.ResultsThe median follow-up was 20.5 months (range, 13 to 59 months; mean, 23.3 months). Among 17 patients in the IPR group, strictures developed in 2 patients (11.7%), and among 53 patients in the DR group, strictures developed in 8 patients (18.6%, p=0.709). The incidences of impotence and incontinence were similar in both groups (17.6% and 0% in the IPR group vs. 27.9% and 4.6% in the DR group, p=0.520 and 1.000, respectively). The time to spontaneous voiding and the duration of suprapubic diversion were significantly shorter in the IPR group (average 27.3 and 33.4 days, respectively) than in the DR group (average 191.6 and 198.1 days, respectively; p<0.001 and <0.001).ConclusionsIPR may provide comparable outcomes to DR and allow for shorter times to spontaneous voiding and reduce the duration of suprapubic diversion.

Resultant hypospadias after epispadias repair in bladder exstrophy patients: a difficult surgical task with high complication rate

Background/Purpose The aim of this study was to analyze the complication rate in male bladder exstrophy (BE) patients undergoing flap or graft urethroplasty for the repair of resultant hypospadias after epispadias repair. Methods We retrospectively reviewed the charts of 22 male BE patients who underwent 24 urethroplasties for resultant hypospadias between 2000 and 2009. Median patient age was 4.2 (range, 1.5-26.5) years, and median follow-up was 7.5 (range, 0.8-10.3) years. Meatal location after epispadias repair was midshaft in 6 cases and proximal shaft in 15. Complications were compared in relation to meatal position, type of urethroplasty (no graft vs graft), use of second-layer coverage of the urethroplasty, and use of suprapubic diversion. Results Overall, complications developed in 12 (50%) patients, including 10 urethrocutaneous fistulas and 2 urethroplasty dehiscence. Univariate analysis failed to show any differences between complicated and uncomplicated cases in all the variables. Only the 3 cases undergoing a 2-stage repair had fully successful outcomes. Conclusions Urethroplasty in patients with BE has a high complication rate. Quality of local tissue and presence of scarring are possibly the 2 major determinants of a poor outcome. A staged repair seems the safest, although this commits the patient to 2 procedures.

Delayed repair is the ideal management for posterior urethral injuries- For the motion

Posterior urethral injuries are seen in trauma cases with pelvic fracture. The time-tested and honored method of management is immediate supra-pubic diversion followed by delayed repair. Immediate alignment as a management option is not new. It was abandoned 30 years ago due to high incidence of incontinence and impotence. However, of late there is a tendency towards immediate management of these injuries with various endoscopic maneuvers. Unfortunately, there is little evidence supporting this. Even these evidences are of limited in number and of limited duration of follow-up.

Management of Urethral Stent Failure for Recurrent Anterior Urethral Strictures

BackgroundUrethral stent placement for recurrent anterior urethral strictures may cause restenosis and complications. ObjectiveTo describe our experience with patients who had restenoses and complications following urethral stent placement for the treatment of recurrent anterior urethral strictures. Design, setting, and participantsWe evaluated retrospectively the records of 13 men with anterior urethral stricture who experienced restenosis and complications after stent insertion. We recorded stent position, prestent and poststent urethral procedures, restenosis location, stent-related complications, and management of stent failures. Surgical procedureThe stent was removed en bloc with the whole strictured urethral segment or wire by wire after a ventral or a double-ventral plus dorsal-sagittal urethrotomy and stent section. MeasurementsSuccessful outcome was defined as standard voiding, without need of any postoperative procedure, and full recovery from complications. Results and limitationsFour patients did not undergo surgery and the stent was left in situ. Of these patients, two required permanent suprapubic cystostomy. Nine patients underwent challenging surgical stent removal and salvage urethrostomy: After the first stage, three patients are waiting for further reconstructive steps, five elected the urethrostomy as a permanent diversion, and one completed the staged reconstruction using a buccal mucosa graft at the second stage. After surgery, seven of the nine patients (77.8%) were free of strictures and stent-related complications, while a restenosis occurred in two of the nine (22.2%) cases. ConclusionsThe management of urethral stent failure represents a therapeutic challenge. The stent risks converting a simple stenosis into a complex stenosis requiring a staged urethroplasty, a definitive urethrostomy, or a permanent suprapubic diversion.

Catheter balloon‐related urethral trauma in children

To review urethral injuries arising from incorrect balloon inflation in children undergoing urinary catheterisation. Retrospective review from 1995-2006. Children who sustained catheter-related injury at The Children's Hospital at Westmead were identified through medical records database and reviewed. Six patients were identified over the 11-year period. All six were boys. Age ranged from <1 month to 16 years. All but one occurred in hospital. All injuries were confirmed by urethrogram. Bulbar and prostatic urethra was involved in an equal number of children studied. Three patients required suprapubic catheters. Follow-up imaging revealed healing without stricture in all patients. Balloon-related urethral trauma can be avoided by educating health-care professionals on proper placement and confirmation of position of catheter. Though there were no long-term complications noted, a temporary suprapubic diversion may be needed.

Single Stage Single Layer Urethroplasty

A total of 153 patients underwent surgical repair of hypospadias by single stage single layer urethroplasty (Yadav's Technique) over last 26 years by a single surgeon. Medium age of the patients at the time of surgery was 4.7 years (range 1 year to 12 years). Associated chordee was corrected at the same stage followed by modified Denis Browne repair along with dorsal slit to release tension over the secure line. None of the cases had suprapubic diversion of urine. A 6F or 8F infant feeding tube was kept as stent earlier for 7 to 9 and now for 5 days only. The results were cosmetically good in 123 cases, satisfactory in 21 and poor in 9 patients. Urethrocutaneous fistulae were seen in 4.5% patients, distal breakdown of repair in 1.3% whereas none of the cases had stricture or residual chordee. This simple technique can be used for all types of hypospadias with low complication rate and good functional results. Moreover being a single stage technique, it is economical and with satisfactory results.