Photo Credit: Nataliia Nesterenko
Researchers confirmed the viability of dorsal inlay graft (DIG) urethroplasty as a secure and efficient choice for the treatment of pediatric revision hypospadias repair.
The following is a summary of “Surgical and functional outcomes of Dorsal Inlay Graft urethroplasty in revision vs primary hypospadias repair in the pediatric age,” published in the January 2024 issue of Pediatrics by Gnech et al.
In recent years, Dorsal Inlay Graft (DIG) urethroplasty has become widely accepted for primary hypospadias repair; however, its safety and efficacy in revision surgery have remained unexplored.
Researchers conducted a retrospective study to evaluate and compare the complication rates and functional outcomes associated with DIG surgery in revision versus primary hypospadias repair.
They involved 53 consecutive DIG urethroplasties conducted by a single surgeon at their institution, with patients categorized into two groups, primary repair and redo-urethroplasty. Each group underwent meticulous documentation of standard pre-operative characteristics, surgical details, complication rates, and uroflowmetry parameters.
The results showed 53 DIG urethroplasties, 21 (39.6%) were primary procedures, and 32 (60.4%) were redo surgeries. As anticipated, the two groups exhibited a notable difference in median age at surgery, with primary interventions performed at 20 months and revision surgeries at 68.5 months (P<.001). Moreover, 100% of primary interventions involved a preputial graft, while only 6.3% of revision DIG urethroplasties used preputial grafts, with 93.8% utilizing buccal grafts (P<.001). Catheterization time (7 vs. 8 days, P=.155) and postoperative complication rates (14.3% vs. 9.4%, P=.581) demonstrated comparable results between the primary and revision surgery groups, respectively (all P>.05). Uroflowmetry analysis for 42 out of 53 patients during follow-up revealed 63% with abnormal uroflowmetry and 37% with equivocal parameters, with no discernible difference between the two groups.
They concluded that the viability of DIG urethroplasty as a secure and efficient choice for the treatment of revision hypospadias repair.
Source: sciencedirect.com/science/article/abs/pii/S1477513124000159