COMPARATIVE STUDY OF INVERTING SUTURELINE VERSUS OVER AND OVER CONTINUOUS SUTURING IN HYPOSPADIAS REPAIR

Basharat Ali Khan, Muhammad Ali Shah, Faraz Basharat Khan

Abstract


Background: Hypospadias is one of the most common congenital anomalies of the male
newborns affecting 1 in 300. Urethral meatus lies ectopically on the ventral surface of penis
proximal to its normal position. There is defective development of urethral spongiosum and
ventral prepuce. Various degrees of chordee may be associated. Objective of the study was to
study the incidence of urethrocutaneous fistula formation after hypospadias repair employing two
different suturing techniques. This Prospective Randomised Descriptive Clinical Trial was
conducted in Department of Surgery, Fauji Foundation Hospital, Rawalpindi and Basharat
Hospital, Rawalpindi, during a period of five years from January 2005 till December, 2009.
Methods: A prospective study of 100 patients of glanular/penile hypospadias requiring repair was
completed from January, 2005 till December, 2009. Fifty of these patients had urethral tube
reconstruction using conventional over and over continuous suturing technique (Group-1). In
another group of fifty patients continuous inverting sutures (Connel technique) commonly used in
intestinal anastomosis was employed (Group-2). Polyglycolic acid sutures 4/0 to 6/0 as
appropriate were used for all the repairs in both the groups by the same surgeon. Results: Six
(12%) urethrocutaneous fistulas formed in the Group-1 of fifty patients with over and over
continuous suturing as compared to 4 (8%) in Group- II with equal number of patients where
inverting suture technique was used. Conclusion: Inverting sutures reduce the incidence of
urethrocutaneous fistula formation in hypospadias repair.
Keywords: hypospadias, urethroplasty, urethrocutaneous fistula

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References


Baskin LS, Ebbers MB, Hypospadias: Anatomy, etiology and

technique. J Pediatr Surg 2006;41:463–72.

Hayashi Y, Kojima Y, Current concepts in hypospadias

surgery. Int J Urol 2008;15:651–64.

Shehla SM: Use of TIP principle for repair of nonglanular

recurrent post hypospadias repair urethrocutaneous mega

fistula. Eu J Paediatr Surg 2009;19:395–8.

Welch KJ, Hypospadias; In Ravitch MM, Welch KJ, Benson

CD, et al. (Eds). Paediatric Surgery. 3rd ed. Chicago: Year

Book Medical Publishers; 1979. p. 1353–76

Duckett JW. Hypospadias repair. In O Donnell, B (Editor)

Paediatric Urology 3rd ed. Surrey, England: Butterworth

Company; 1991.

Albers N, Ulrichs C, Gluer S, Hiort O, Sinnicker GH,

Mildenberger H, et al. Etiologic classification of severe

hypospadias: implications for prognosis and management. J

Pediatr 1997;131:386–92.

Vander Meulen JC. Hypospadias monograph. Leiden. The

Netherlands: AG Stenfert Kroesc, NV;1964.

Yeap BH, Mohan N. hypospadias from the perspective of a

single surgeon practice in Malaysia.Med J Malaysia

;63:388–90.

Al Saeed G, Gamal A. Versatility of tubularized incised plate

urethroplasty in the management of different types of

hypospadias: 5 years experience. Afr J Paediatr Surg

;6(2):88–92.

Balantyne GH. Intestinal suturing. Review of the

experimental foundations for traditional doctrines. Dis Colon

Rectum. 1983; 26(12):836–43.


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