Hypospadias Reconstructive Surgery Modification Using Double Layer Urethral Stent

Background: Several surgical reconstructive procedures are introduced to repair a hypospadiasis while post-operative complications have still remained high. Poor tissue handling, anastomotic site ischemia, tension on the anastomotic line, and distal obstruction are suggested as the main risk factors contributing to post-operative complications. This article is the introduction of a simple technical modification to perform a uniform straight tension free urethroplasty that is supposed to decrease post hypospadias repair complications. Methods: We used a 6F silicon Foley catheter and covered it by a part of 10 F Nelaton catheter at the most distal part of the Foley. To facilitate the covering and uncovering process, weincised the Nelaton catheter in one side through the whole length.We performed a two-layer closure urethroplasty over our double layer stent and finally uncovered the Foley catheter, which remains in the bladder as a trans-urethral stent and also for further bladder drainage. ResultsandConclusions: In our innovative method of urethral stenting, wehave suggested to replace the transurethral stent with a tension free lower size catheter easily and safely at the end of procedure, which helps decrease suture line tension and is supposed to improve the local circulation.