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INVESTIGATORS AT THE CHILDREN'S HOSPITAL OF NEW YORK ANNOUNCE A BREAKTHROUGH IN HYPOSPADIAS SURGERY

A group of investigators at the Children's Hospital of New York have reported a significant breakthrough in the management of patients undergoing hypospadias surgery at that institution. The group under the direction of Dr. Terry W. Hensle has looked at 64 patients undergoing distal hypospadias repair over a 3 year period. The investigators used short term postoperative catheterization removing the urethral stent less than 24 hours after the procedure with results which are comparable to if not better than series where the catheter was left in for a much longer period of time.

Dr. Hensle, who is The Given Foundation Professor of Urology at The Columbia University College of Physicians and Surgeons, described the change as significant in terms of patient care and postoperative management. The majority of patients undergoing a tubularized incised plate urethroplasty (TIP) repair have the catheter left in somewhere between 3 and 7 days. Dr. Chad Ritch, another one of the investigators, described the widespread acceptance on the part of parents having only short term catheterization for their child following this kind of surgery.

The group looked at overall success rate, including complications, and found that the overall group had a urethrocutaneous fistula rate of 6%, which is lower than most reported series where the catheter is left in for a much longer period of time. There was no evidence of other postoperative complications, such as postoperative meatal stenosis or bleeding. Dr. Hensle described the change in postoperative management as significant and the real benefit not only for the child, but for the parents undergoing this kind of stressful and often complicated postoperative care.

At present, all patients undergoing primary hypospadias repair will have short term catheterizations, unless there is some contraindication such as those having had previous urethral surgery or complex proximal primary hypospadias lesions. Further information can be obtained through the Division of Pediatric Urology at 212-305-8510 or by contacting Dr. Hensle directly by email at twhenslemd@aol.com.

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