Hypospadias repair in an outpatient setting without proximal urinary diversion: experience with 113 urethroplasties.

A total of 113 consecutive patients underwent surgical repair of hypospadias. None had previously undergone a repair procedure. The median age of the patients at the time of surgery was 24 months (range, 5 months to 13 years). A meatal-based flap modified Mathieu technique was used in 48 children and a single- or double-faced transverse preputial island flap was used in 58 children. Urinary diversion was not performed. A 7F silicone rubber urethral stent with multiple perforations that drained freely was used in all cases. The stent was left indwelling for 7 days after meatal-based flap repairs and for 12 days preputial island flap repairs. Seventy-nine patients (70%) were discharged from the hospital the day of the operation. The results were cosmetically satisfactory in all cases. A total of 23 patients developed complications. Sixteen (14%) developed a urethrocutaneous fistula, 2 developed a stricture (1.7%), and 5 developed a urethral diverticulum (4.5%). There were no fistulas and only one stricture in the meatal based flap repairs. For 20 patients who suffered complications, a single outpatient surgical procedure corrected the problem. The remaining 3 patients required more than two surgical procedures. All complications were resolved within 12 months of the hypospadias repair.