Urologia Internationalis

Original Paper

Suture Materials: Do They Affect Fistula and Stricture Rates in Flap Urethroplasties?

Cimador M. · Castagnetti M. · Milazzo M. · Sergio M. · de Grazia E.

Author affiliations

Paediatric Surgery Unit, ‘Istituto Materno Infantile’, University of Palermo, Palermo, Italy

Related Articles for ""

Urol Int 2004;73:320–324

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: July 01, 2003
Accepted: March 30, 2004
Published online: December 13, 2004
Issue release date: December 2004

Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 1

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Abstract

Introduction: The effect of suture materials on urethroplasty complications is debated. Indeed, materials with a delayed absorption might either reduce the incidence of fistulas by ensuring a prolonged approximation of neo-urethral edges or increase the risk of urethral strictures due to a prolonged tissue reaction during suture absorption. We retrospectively evaluated the role of suture materials in the complication rate of urethroplasty procedures performed in our institution over a 10-year period. Patients and Methods: Three hundred and thirty-six boys undergoing a flap procedure (parameatal based, preputial tube, or onlay preputial flap) for hypospadias repair were considered for this study. The patients were stratified into two groups according to the suture material used for urethroplasty. Polyglactin (Vicryl®), a polyfilament with intermediate absorption, was used in 254 group A patients, whereas polydioxanone (PDS®), a monofilament with prolonged absorption, was used in 82 group B patients. The success of a one-stage repair and stricture and fistula rates were evaluated. Results: A successful one-stage repair was achieved in 82% of the group A and in 83% of the group B patients (p = 0.97). No statistically significant differences were noted in fistula and/or stricture rates in the two groups, even considering each procedure separately. Conclusions: This series suggests that suture materials do not affect the complication rate in flap urethroplasty procedures. Appropriate technique, meticulous surgery, and surgeon experience seem to be more crucial factors. A randomized trial is warranted.

© 2004 S. Karger AG, Basel




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References

  1. Duckett JW, Baskin LS: Hypospadias; in Gillenwater JC, Grayhack JT, Howard SS, Duckett JW (eds): Adult and Pediatric Urology, ed 3. St. Louis, Mosby, 1996, pp 2549–2587.
  2. Mouriquand PD, Persad R, Sharma S: Hypospadias repair: Current principles and procedures. Br J Urol 1995;76(suppl 3):9–22.
    External Resources
  3. Ulman I, Erikci V, Avanoglu A, Gökdemir A: The effect of suturing technique and material on complication rate following hypospadias repair. Eur J Pediatr Surg 1997;7:156–157.
  4. Di Sandro M, Palmer JM: Stricture incidence related to suture materials in hypospadias surgery. J Pediatr Surg 1996;31:881–884.
  5. Duckett JW: MAGPI (meatoplasty and glanuloplasty): A procedure for subcoronal hypospadias. Urol Clin North Am 1981;8:513–519.
  6. Mathieu P: Traitement en un temps de l’hypospadias balanique ou juxtabalanique. J Chir (Paris) 1932;39:481.
  7. De Grazia E, Cigna RM, Cimador M: Modified-Mathieu’s technique: A variation of the classic procedure for hypospadias surgical repair. Eur J Pediatr Surg 1998;8:98–99.
  8. Duckett JW Jr: Transverse preputial island flap technique for repair of severe hypospadias. Urol Clin North Am 1980;7:423–430.
  9. Elder JS, Duckett JW, Snyder HM: Onlay island flap in the repair of mid and distal penile hypospadias without chordee. J Urol 1987;138:376–379.
  10. Ghali AM: Hypospadias repair by skin flaps: A comparison of onlay preputial island flaps with either Mathieu’s meatal-based or Duckett’s tubularized preputial flaps. BJU Int 1999;83:1032–1038.
  11. Castañon M, Muñoz E, Carrasco R, Rodò J, Morales L: Treatment of proximal hypospadias with a tubularized island flap urethroplasty and the onlay technique: A comparative study. J Pediatr Surg 2000;35:1453–1455.
  12. Wiener JS, Sutherland RW, Roth DR, Gonzales ET Jr: Comparison of onlay and tubularized island flaps of inner preputial skin for the repair of proximal hypospadias. J Urol 1997;158:1172–1174.
  13. Snodgrass WT: Tubularized, incised plate urethroplasty for distal hypospadias. J Urol 1994;151:464–465.
  14. Smith DP: A comprehensive analysis of a tubularized incised plate hypospadias repair. Urology 2001;57:778–782.
  15. Sugarman ID, Trevett J, Malone PS: Tubularization of the incised urethral plate (Snodgrass procedure) for primary hypospadias surgery. BJU Int 1999;83:88–90.
  16. Uygur MC, Erol D, Germiyanoglu C: Lessons from 197 Mathieu hypospadias repairs performed at a single institution. Pediatr Surg Int 1998;14:192–194.
  17. Uygur MC, Unal D, Tan MO, Germiyanoglu C, Erol D: Factors affecting outcome of one-stage anterior hypospadias repair: Analysis of 422 cases. Pediatr Surg Int 2002;18:142–146.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: July 01, 2003
Accepted: March 30, 2004
Published online: December 13, 2004
Issue release date: December 2004

Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 1

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN


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