DOUBLE-TUBE STENTS DEVICE FOR NEO-URETHRA RECONSTRUCTION OF SEVERE TYPE OR RE-DO HYPOSPADIAS REPAIR
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DOUBLE-TUBE STENTS DEVICE FOR NEO-URETHRA RECONSTRUCTION OF SEVERE TYPE OR RE-DO HYPOSPADIAS REPAIRJesun Lin 1, 2, Jian Ting Chen1, Herng-Jye Jiang1, Bai-fu Wang1, Ming-Chih Chou 21Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan2Institute of Medicine , Chung Shan Medical University, Taichung, Taiwan

Purpose of the study :

  • Urine diversion and urethral stent are commonly used in the reconstruction of severe type and re-do hypospadias

    • Conventional methods of diversion :

      Bladder spasm and wound infection

    • Double-tube stents device :

      Intraurethral secretion and exudation are periodically cleansed by the voiding stream.

      Materials and Methods :

  • The procedures of the double-tube stents device: (Fig.1~Fig.3)

    • (1)The fine inner tube (from urethral meatus to the bladder) for temporal urine drainage

      • 5Fr. or 6Fr. in caliber that will minimize the bladder irritation

      • It will be removed within 48 hours after operation.

    • (2) The outer silicon bigger caliber (9Fr or 12Fr) fenestrated short tube for uretehra stent

      • From the meatus of the neo-urethra to distal end of the external sphincter

      • Anchored to the glans penis with a transfixing sututure of 5-0 Black silk

      • It will be maintained for about two weeks

    • (3)The patient may pass urine from the outer silicon tube after removing the inner fine tube (Fig.4)

      Results :

  • 36 patients (age 1-3 years old) were enrolled in this double-tube stents device in recent three years

  • All children were discharged on postoperative day three or four.

  • The most common complications were treated subsequently with uneventful results

    • (1) tube slipped off, 3

    • (2) erosion of the glans penis, 2

    • (3) urethral meatal stenosis, 2

    • (4) urethro-cutaneous fistula, 3

      Conclusion:

  • Advantage of the double-tube stents device

    • It could shorten the admission period

    • It could diminish the bladder spasm

    • The urination from the silicon fenestrated tube could periodically flush and cleanse the discharge of the urethra

    • It could minimize the infection of the urethra

Fig. 1

Fig. 2

Fig. 3

Fig. 4


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