Comparison Of Short Urethral Stent Tubes And Catheters In Children With Hypospadias In The Postoperative Period

Objective:To observe the use of two types of stent tubes,a short urethral stent tube and a conventional catheter,in patients with hypospadias treated with the Snodgrass procedure,in order to provide a theoretical basis for the prevention of postoperative urethral fistula and to improve the overall outcome of hypospadias.Materials and Methods:We retrospectively analyzed 152 children with hypospadias treated with Snodgrass surgery from January 2012 to December 2019.152 children were routinely catheterized after surgery.152 children were divided into two groups: In groupⅠ,children who used a new urethral stent short tube instead of a traditional urinary catheter one week after the operation,the urinary stent short tube was removed about one month after the operation,a total of 64 cases,the median age: 3years and 6 months.Group Ⅱ consisted of 88 children(median age: 3 years and 9months)who did not use the new short urinary stent and were left with a conventional catheter until one month after surgery.In both groups,the observation period was within 6 months after surgery,and there was no significant difference in the preoperative preparation and postoperative medication.The incidence of postoperative urethral fistula was compared between the two groups of children,and the satisfaction of family members was followed up.Results:In this study,8 cases of urethral fistula occurred in group Ⅰ,with an incidence of 12.50%,and 23 cases of urethral fistula occurred in group Ⅱ,with an incidence of26.14%.The incidence of urethral fistula in group Ⅰ was significantly lower than that in group Ⅱ,with a statistically significant difference(p = 0.039).The satisfaction of the families of children in Group Ⅰ(79.69%)was significantly higher than that of the families of children in Group Ⅱ(54.55%),with a statistically significant difference(p=0.002),Further analysis revealed that disease staging(p=0.598),BMI(p = 0.985),and season of surgery(p = 0.861)were not the most important factors for the use of the Snodgrass procedure.Snodgrass surgery in patients with suburethral cleft was not an influential factor for postoperative urethral fistula.In contrast,age at surgery(p = 0.011)was significant for the occurrence of postoperative urethral fistula after Snodgrass,and the incidence of urethral fistula was less in children who completed surgical treatment before the age of 3 years than in children who underwent surgical treatment after the age of 3 years.Conclusion:1.The use of a short urethral stent tube instead of a traditional catheter one week after Snodgrass in patients with hypospadias reduces the incidence of urethral fistula,and the structure of the short urethral stent tube is simpler,relatively easy to make,with low technical content,reducing the cost of treatment,while reducing the difficulty of parental care,improving the satisfaction rate of the child’s family,which has a certain effect on the improvement of the overall outcome of hypospadias and is worthwhile.It is worth promoting in clinical practice.2.Once detected,if there are no specific contraindications to surgery,hypospadias should be treated at as young an age as possible,not only to reduce complications,but also to reduce the psychosocial problems associated with surgery.However,the exact age range for surgery is worth further discussion.