J G Van Savage1, L G Palanca, B L Slaughenhoupt. 1. Division of Pediatric Urology, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Abstract
PURPOSE: Dressings following hypospadias repair have the benefits of gentle compression for hemostasis, immobilization of the wound and formation of a "hermetic seal." Potential disadvantages include producing ischemia, infection and pain during dressing removal. We compare the success and complications of hypospadias repair with and without dressings in a prospective randomized manner. MATERIALS AND METHODS:Children with hypospadias were randomized either to receive or not receive a transparent film dressing for 2 days. A written informed consent was obtained. Hypospadias repair was performed in 100 consecutive patients. Study exclusion criteria were known coagulopathy and oozing at the end of the case. Criteria for success were a glanular meatus, single forward directed stream, unimpeded voiding, absence of penile chordee, good cosmesis and no need for any secondary procedure. All but 1 hypospadias repair preserved the integrity of the urethral plate. Statistical significance was considered at p <0.05. RESULTS: We were able to randomize between the dressed and nondressed groups based on fresh versus redo cases, position of the urethral meatus, severity of chordee, use of epinephrine, duration of surgery, type of repair and chordee correction (p >0.05). Of 49 patients 44 (90%) had successful results in the dressed and nondressed groups. Postoperative calls were more common in the undressed group (p = 0.02) but no particular complication was more common in either group (p >0.05). Mean followup was 1 year, and there was no clinical or statistical difference between the dressed and nondressed groups with regard to success of the operation (p >0.05). CONCLUSIONS: The success rate for hypospadias surgery that preserves the urethral plate is independent of dressing usage. Dressings may not be indicated for all hypospadias repairs.
RCT Entities:
PURPOSE: Dressings following hypospadias repair have the benefits of gentle compression for hemostasis, immobilization of the wound and formation of a "hermetic seal." Potential disadvantages include producing ischemia, infection and pain during dressing removal. We compare the success and complications of hypospadias repair with and without dressings in a prospective randomized manner. MATERIALS AND METHODS:Children with hypospadias were randomized either to receive or not receive a transparent film dressing for 2 days. A written informed consent was obtained. Hypospadias repair was performed in 100 consecutive patients. Study exclusion criteria were known coagulopathy and oozing at the end of the case. Criteria for success were a glanular meatus, single forward directed stream, unimpeded voiding, absence of penile chordee, good cosmesis and no need for any secondary procedure. All but 1 hypospadias repair preserved the integrity of the urethral plate. Statistical significance was considered at p <0.05. RESULTS: We were able to randomize between the dressed and nondressed groups based on fresh versus redo cases, position of the urethral meatus, severity of chordee, use of epinephrine, duration of surgery, type of repair and chordee correction (p >0.05). Of 49 patients 44 (90%) had successful results in the dressed and nondressed groups. Postoperative calls were more common in the undressed group (p = 0.02) but no particular complication was more common in either group (p >0.05). Mean followup was 1 year, and there was no clinical or statistical difference between the dressed and nondressed groups with regard to success of the operation (p >0.05). CONCLUSIONS: The success rate for hypospadias surgery that preserves the urethral plate is independent of dressing usage. Dressings may not be indicated for all hypospadias repairs.
Authors: Roberto Méndez-Gallart; María García-Palacios; Pablo Rodríguez-Barca; Elina Estévez-Martínez; Ana Lema Carril; Adolfo Bautista-Casasnovas Journal: Can Urol Assoc J Date: 2017-01-12 Impact factor: 1.862
Authors: Fábio de Oliveira Vilar; Flávia Cristina Morone Pinto; Amanda Vasconcelos Albuquerque; Ana Gabriela Santos Martins; Luiz Alberto Pereira de Araújo; José Lamartine de Andrade Aguiar; Salvador Vilar Correia Lima Journal: Int Braz J Urol Date: 2016 Nov-Dec Impact factor: 1.541