COMPARATIVE STUDY OF POLYDIOXANONE (PDS) AND POLYGLACTIN (VICRYL) IN SINGLE STAGED HYPOSPADIAS REPAIR - OUR EXPERIENCE

Abstract

Hypospadias is the second most common congenital urogenital anomaly in male children followed by cryptorchidism. Although various surgical techniques are available for the successful correction of hypospadias repair, the selection of suture material plays a vital role in the cosmetic and functional outcomes of hypospadias repair, especially the development of urethrocutaneous fistula.

Objective: The main objective of the study is to compare the surgical outcomes following usage of 6/0 polydioxanone (PDS) and 6/0 polyglactin (vicryl) in single staged hypospadias repair, especially urethrocutaneous fistula formation.

Materials and Methods: This is a prospective observational hospital- based study done in the Department of Pediatric Surgery at a tertiary care hospital, during the period from April 2022 to March 2023. A total of 48 hypospadias patients were taken and divided into two groups A and B. Group A consisted of 25 patients who were repaired using 6/0 polyglactin and group B consisted of 23 patients who were repaired using 6/0 polydioxanone.

 Results: The mean age of group A was 4.7 +/- 1.2 years and mean age of group B patients was 3.5

+/- 2 years. Out of the 48 children, Theirsch Duplay repair was done in 79.16% cases ( n=38), Meatal

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advancement and glanuloplasty incorporated (MAGPI) was done in 10.41% cases (n =5), longitudinal dorsal island flap (LDIF) was done in 6.25% cases (n=3) and Mathieu’s repair was done 4.16% cases (n=2). In Group A, the complication rate was 48% (n= 12 out of 25 cases) and in Group B, it was 17.39% (n= 4 out of 23 cases). The most common complication noted was urethrocutaneous fistula (UCF), as 10 cases had UCF in Group A (40%) and 3 cases in group B (13.04%). The next most complication being meatal stenosis with 4 cases in Group A (16%) and two cases in Group B (8.6%). These values of complication rates are subjected to change with increase in the number of subjects and duration.

CONCLUSION: Polydioxanone is considered one of the suitable suture material in hypospadias repair with minimal complication rate and better outcome rates. Urethrocutaneous fistula is the most common complication following hypospadias repair and a difficult one to treat.