Urethral stent in hypospadias repair

摘要

Dear Sir, Hypospadias repair is a well-accepted procedure to return form and function to these patients. However, complications including fistula formation and meatal stenosis are still relatively common. Buson et al. found that patients who had urinary diversion had lower rate of complications compared to those who did not have urinary diversion (18.9% vs 4.6%). However, the subject of type of urinary diversion and stenting in hypospadias repair has been widely discussed. Studies have found that urinary diversion can avoid the risk of urinary retention, straining and increased risk of fistulae and meatal stenosis. However, bladder spasm is a common complication in bladder catheteriza-tion leading to patient distress and discomfort. Further more, parents often find it difficult looking after the catheter, which can deflate or break (Figure 1) secondary to trauma, causing distress to patients and parents. When it dislodges, the catheter tip, which is of wider diameter, can disrupt the repair. If this occurs prematurely, a catheter may need to be re-inserted, imposing further anaesthetic risk to the patient. Supra-pubic catheterization is therefore a good alternative of urinary diversion.