URETHROCUTANEOUS FISTULA FOLLOWING SNODGRASS VERSUS TWO STAGE AIVAR BRACKA REPAIR OF DISTAL PENILE HYPOSPADIAS IN MALE CHILDREN: A RANDOMIZED CONTROL TRIAL

Habib Ullah Shah, Huma Gul, Rashid Khan, Muhammad Marwat

Abstract


Background: Hypospadias is the most common congenital malformation of the urethra with the prevalence of 1 in 200-300 live male births. The objective of this trial was to compare the frequency of urethrocutaneous fistula between Snodgrass and two staged Aivar Bracka repair of distal penile hypospadias in male children.
Material & Methods: This RCT was conducted in Department of Plastic & Reconstructive Surgery, Hayatabad Medical Complex, Peshawar, Pakistan from 1st June 2013 to 31st May 2014. 64 male patients were randomly allocated to two surgical procedures, 32 to experimental (Snodgrass) group and 32 to control (two stage Aivar Bracka) group. Age in years, age groups and presence of urethrocutaneous fistula were variables. Age in years was analyzed by mean, SD and range and other variables by count and percentage. McNemar chi-square test was applied to see the significance of difference between the experimental and control groups in terms of frequency of urethrocutaneous fistula at alpha 0.05.
Results: Mean age in experimental (Snodgross) group was 6.74 years±1.26 & in control (Aivar Bracka) group 6.71 years ±1.29. The urethrocutaneous fistula was present in three (9.38%, 80% CI 2.77-15.99%) cases in experimental (Snodgross) group and in six (18.75%, 80% CI 9.91-27.59%) cases in control (Aivar Bracka) group. McNemar chi-square test showed no significant difference between the experimental and control groups in terms of frequency of urethrocutaneous fistula.
Conclusion: The results are comparable for Snodgrass repair and two stage Aivar Bracka repair for distal penile hypospadias in male children in terms of frequency of urethrocutaneous fistula in our population.

Keywords


Urethrocutaneous fistula; Snodgrass; Aivar Bracka; Hypospadias, Distal penile hypospadias.

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References


Tabassi KT, Mohammadi S. Tunica vaginalis flap as a second layer for tabularized incised plate urethroplasty. Urol J 2010;7:254-7.

Williams NS, Bulstrode CJK, O’Connell PR. Bailey and Love’s short practice of surgery. 25th ed. London: Edward Arnold; 2008. p. 1362-3.

Al-Saied G, Gamal A. Versatility of tabularized incised plate urethroplasty in the management of different types of hypospadias: 5-year experience. Afr J Paediatr Surg 2009;6:88-92.

Morales-Suarez-Varela MM, Toft GV, Jensen MS, Ramlau-Hansen C, Kaerlev L, Thulstrup AM, et al. Parental occupational exposure to endocrine disrupting chemicals and male genital malformations: a study in the Danish national birth cohort study. Environ Health 2011 Jan 14;10(1):3.

Bhattacharya S. A modified tubularised incised plate urtetheroplasty technique and a revised hypospadias algorithm. Indian J Plast Surg 2010 Jan-Jun;43(1):21-7.

Haxhirexha KN, Castegnetti M, Rigamonti W, Manzoni GA. Two-stage repair in hypospadias. Indian J Urol 2008; 24(2):226-32.

Irfanullah, Ikramullah, Nawaz A, Khan A, Ullah T. Frequency of urethrocutaneous fistula formation with two staged Bracka’s repair of hypospadias: experience at Hayatabad Medical Complex, Peshawar. Ann Pak Inst Med Sci 2012;8(4):213-5.

Shirazi M, Rahimi M, Noorafshan A. Single vs. double layer suturing method repair of the urethral plate in the rabbit model of hypospadias. Cent European J Urology 2016 Nov 30;69 (4):425-30. doi: 10.5173/ceju.2016.875

Ahmad A, Shadman M, Ullah F, Hayat W, Ullah T. A single center experience of urethro-cutaneous fistula in post Aivar Bracka repair meatal stenosis. Pak J Surg 2018 Jul-Sep; 34(3):192-5.

Stats Calculator. Confidence interval calculator for proportion. Accessed 1 Nov 2015. Allto Consulting, Chapel Allerton, Leeds, UK. Available at: https://www.allto.co.uk/tools/statistic-calculators/confidence-interval-for-proportions-calculator/

Zar JH. Biostatistical Analysis. 5th ed. Englewood Clifts, New Jersey: Prentice-Hall, Inc. p.127.

Pegano M, Gauvreau K. Principals of Biostatistics. 2nd ed. Boston, MA, USA: Cengage Learning; 2000. p.349-52.

Motulsky HJ. GraphPad, QuickCalcs. McNemar’s test to analyze experimental studies. Accessed 1 Nov 2015. GraphPad Software, San Diego, CA, USA. Available at: https://www.graphpad.com/quickcalcs/McNemar1.cfm

Khan M, Majeed A, Hayat W, Ullah H, Naz S, Shah SA, et al. Hypospadias repair: a single center experience. Plast Surg Int 2014; 2014:453039. DOI: 10.1155/2014/453039.

Obaidullah, Aslam M. Ten-year review of hypospadias surgery from a single center. British J Plastic Surg 2005 Sep; 58(6):780-9. DOI: 10.1016/j.bjps.2005.01.015.


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