Hypospadias Reconstructive Surgery Modification Using Double Layer Urethral Stent

Abstract

Background: Several surgical reconstructive procedures are introduced to repair a hypospadiasis while post-operative complications have still remained high. Poor tissue handling, anastomotic site ischemia, tension on the anastomotic line, and distal obstruction are suggested as the main risk factors contributing to post-operative complications. This article is the introduction of a simple technical modification to perform a uniform straight tension free urethroplasty that is supposed to decrease post hypospadias repair complications. Methods: We used a 6F silicon Foley catheter and covered it by a part of 10 F Nelaton catheter at the most distal part of the Foley. To facilitate the covering and uncovering process, we incised the Nelaton catheter in one side through the whole length. We performed a two-layer closure urethroplasty over our double layer stent and finally uncovered the Foley catheter, which remains in the bladder as a trans-urethral stent and also for further bladder drainage. Results and Conclusions: In our innovative method of urethral stenting, we have suggested to replace the transurethral stent with a tension free lower size catheter easily and safely at the end of procedure, which helps decrease suture line tension and is supposed to improve the local circulation.