WOFAPS 2025 8th World Congress of Pediatric Surgery

Zuha Zafar, Batool Fatima, Zahra Auqil, Kashif Bashir

Department of Pediatric Surgery, Mayo Hospital Lahore, Pakistan

Purpose:

Despite widespread use of postoperative urinary catheterization in hypospadias repair, no specific guidelines exist for the timing of catheter removal. The purpose of this study is to evaluate the impact of early versus late urinary bladder catheter removal on postoperative outcomes measured as early and late complications. The study also evaluates hospital stay duration and patient satisfaction to support safer, evidence-based practices in pediatric hypospadias care.

Method:

A randomized controlled trial was conducted from December 2024 to May 2025. Patients aged 6 months till 12 years with hypospadias who underwent tubularized incised plate urethroplasty, the technique previously described by Snodgrass et al. were randomly allocated into 2 groups by computer generated numbers. Group A: Early catheter removal (≤5 days post-op) And Group B: Late catheter removal (>5 days post-op). Primary outcomes included early complications (incidence of surgical site infection, urinary tract infection, bladder spasm, urinary retention, urinary extravasation, bleeding and pain) and late complications (urethrocutaneous fistula, wound dehiscence, meatal stenosis and urethral stricture). Secondary outcomes were duration of hospital stay and patient satisfaction. Statistical analysis was performed using SPSS version 23.0. Comparison of complications in both groups was done by using chi square test. p-value < 0.05 was considered significant.

Results:

Of the total 68 patients, 82.4% had subcoronal hypospadias. In Group A, 11.8% experienced complications, compared to 7.1% in Group B. However, this difference was not statistically significant (Fisher’s exact test, p = 0.681). The odds ratio for complications was 1.73, and 95% confidence intervals overlapped zero, further supporting non-significance. Chi-square analysis of late complications also showed no significant association with timing of stent removal (p = 0.259). The mean hospital stay was significantly shorter in Group A (5.19 ± 0.40 days) than in Group B (8.47 ± 1.31 days), with a highly significant p-value (t = -13.62, p < 0.001). Satisfaction scores were also comparable, indicating no significant difference in patient satisfaction between the two groups

Conclusion:

Early and late stent removal after hypospadias repair had comparable complication rates but early removal was significantly associated with shorter hospital stays. Hence, early stent removal may be a safe and cost-effective strategy in the postoperative management of hypospadias patients resulting in similar outcomes and overall patient satisfaction.