Does the Choice of Suture Material Affect the Incidence of Urethrocutaneous Fistulae After Hypospadias Repair? – A Comparison of Polyglactin 910 with Polydioxanone

Adnan Khalid, Syed Hashim Zaidi, Marvi Baloch, Fahad Saleem


Background: We aimed to assess the incidence of developing postoperative urethrocutaneous fistulae (UCF) while using
either polyglactin 910 or polydioxanone for the repair of subcoronal hypospadias in paediatric patients. Methods: A
multicenter, two-group posttest-only randomized experimental design was adopted for the study. The study was conducted
at PNS Shifa Hospital Karachi, Combined Military Hospital Malir, Military Hospital Rawalpindi and Combined Military
Hospital Multan from 2009 to 2016. Boys between the ages of 1 – 10 years with confirmed diagnosis of subcoronal
hypospadias suitable for single stage repair with the Snodgrass technique and also completing a minimum follow up of 6
months were targeted for the study. The subjects were later randomized into PG group (those undergoing urethral repair
with polyglactin 901) and PD group (those in whom polydioxanone was used). Both descriptive and inferential statistics
were used for data analysis. SPSS v. 21.0 was used for data analysis with p > 0.05 taken as significant value. Results: Two
hundred patients with confirmed diagnosis of subcoronal hypospadias were recruited for the study in the proposed study
period. Twenty-nine patients (29%) in the PG and 26 (26%) in the PD group developed UCF. There were seven (7%) cases
of wound infection in the PG group compared to four cases (4%) in the PD Group; all eleven of the said were among those
who developed UCF. Meatal stenosis was observed in six patients (6%) in the PG group and in nine patients (9%) of the
PD group. No significant difference in the incidence of postoperative urethral fistula formation with the use of polyglactin
910 versus polydioxanone was however reported by the study findings. Conclusion: As there was no significant difference
in the incidence UCF between Polyglactin 910 and Polydioxanone, the choice of suture material should be based on
economical variations and availability of the two products.


Hypospadias, Polyglactin 910, Polydioxanone, Urethrocutaneous Fistula.

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