Mandar Vaidya ¹, Suyog Shetye ², Jyotsna Kulkarni ³

Affiliations
1 Associate Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN
2 Former PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN
3 Assistant Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN

Abstract

Introduction: Hypospadias is defined as a condition where the urethra opens on the ventral aspect of the penis. It is commonly associated with penile curvature, usually ventral and is one of the most common genital birth defects in males. Hypospadias can be treated with numerous different surgical approaches numbering upto 200, and historically has been treated with procedures like Trans-Verse Island Flap (TVIF) on lay, Tubularised Incised-Plate (TIP), vertical preputial island flap, tubularised preputial flap, vertical preputial flap with double skin island etc. Present study was conducted to compare Snodgrass Tubularised Incised Plate Urethroplasty (TIP procedure) and Duckett Onlay Transverse Preputial Patch Urethroplasty for penile hypospadias correction. Material and Methods: Male patients between the age of 2-14 years who underwent correction of penile hypospadias by either of the two techniques viz. TIP (procedure) Urethroplasty and Duckett Onlay Transverse Preputial Patch Urethroplasty were included in the present prospective observational study after written informed consent. Results: The study was carried out with 40 patients and sorted into two groups, i.e. Snodgrass (S) and Duckett (D) group with 20 patients each. No difference was observed among study groups withregards to incidence of individual complications like urethrocutaneous fistula, stricture, or wound infection (p>0.05). However, total complication rate was marginally higher (55%) in Snodgrass’ procedure as compared to Duckett’s procedure (35%). All the cases of stricture (10%) and wound dehiscence (5%) were reported in Snodgrass group.

Keywords

Snodgrass Urethroplasty, Duckett Onlay, Transverse Preputial, Patch Urethroplasty, Penile, Hypospadias, Ventral Penile Curvature

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Kailash Mogal ¹, Mohammed Mithi ², Jyotsna Kulkarni ³

Affiliations
1 Associate Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
2 Former PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Assistant Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN

Abstract

Introduction: Ureteric stents have become one of the most basic and valuable tools in the urological practice. Indwelling ureteral stents provide direct drainage of the upper urinary tract to the bladder without the need for external diversion. The indications for insertion of stents into the urinary tract has expanded significantly during the last decade. However, their use is not free of complications and problems. The present study was designed to observe the clinical profile of patients presenting with obstructive uropathy at a tertiary care centre requiring DJ stents and to study the complications of indwelling DJ stents. Material and Methods: Data collection by meticulous history taking and clinical examination, appropriate laboratory and radiological investigations, operative findings, and follow-up of cases. Results: Study was conducted with 50 patients. nodule was 23%. Mean age of the subjects was 44.32 year. Overall male predominance was seen in present study with 70% males. Obstructive uropathy forms the major indication for DJ stenting followed by upper urinary tract infections (10%). Associated Complications were noticed in 46% of cases. Most common associated complication of DJ stenting was dysuria (24%) and increased frequency (22%). Urinary tract infection, haematuria, and stent migration was seen in 12%, 8% and 4% cases. Conclusion: Double stenting is an easy and effective procedure for the management of obstructive uropathy. However, we recommend that their use must be strictly restricted to selected cases and routine use should be avoided, as they are not free of complications. Moreover, close follow up of stented patients is essential for early detection of complications and a lot of stress should be paid on the counselling of the patients regarding stents complications and their timely removal in order to avoid stent encrustation/migration which could otherwise be highly fatal for the patient.

Keywords

Double J, JJ/DJ Stent, Obstructive Uropathy, Ureteric Stents

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