URETHROCUTANEOUS FISTULA FOLLOWING SNODGRASS VERSUS TWO STAGE AIVAR BRACKA REPAIR OF DISTAL PENILE HYPOSPADIAS IN MALE CHILDREN: A RANDOMIZED CONTROL TRIAL

Abstract

Background: Hypospadias is the most common congenital malformation of the urethra with the prevalence of 1 in 200-300 live male births. The objective of this trial was to compare the frequency of urethrocutaneous fistula between Snodgrass and two staged Aivar Bracka repair of distal penile hypospadias in male children.
Material & Methods: This RCT was conducted in Department of Plastic & Reconstructive Surgery, Hayatabad Medical Complex, Peshawar, Pakistan from 1st June 2013 to 31st May 2014. 64 male patients were randomly allocated to two surgical procedures, 32 to experimental (Snodgrass) group and 32 to control (two stage Aivar Bracka) group. Age in years, age groups and presence of urethrocutaneous fistula were variables. Age in years was analyzed by mean, SD and range and other variables by count and percentage. McNemar chi-square test was applied to see the significance of difference between the experimental and control groups in terms of frequency of urethrocutaneous fistula at alpha 0.05.
Results: Mean age in experimental (Snodgross) group was 6.74 years±1.26 & in control (Aivar Bracka) group 6.71 years ±1.29. The urethrocutaneous fistula was present in three (9.38%, 80% CI 2.77-15.99%) cases in experimental (Snodgross) group and in six (18.75%, 80% CI 9.91-27.59%) cases in control (Aivar Bracka) group. McNemar chi-square test showed no significant difference between the experimental and control groups in terms of frequency of urethrocutaneous fistula.
Conclusion: The results are comparable for Snodgrass repair and two stage Aivar Bracka repair for distal penile hypospadias in male children in terms of frequency of urethrocutaneous fistula in our population.