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CONGRESS OF THE ESPU
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ANTIBIOTIC USE FOLLOWING PRIMARY DISTAL AND MID
PENILE HYPOSPADIAS REPAIR: IS IT NECESSARY?
(A PROSPECTIVE RANDOMIZED STUDY)
Mohamed ELSAWY, Mamdouh ABDULSALAM and A.Nasser ALSAID
Ibn Sina Hospital, Paediatric Urology Unit, Pediatric Surgery department, Kuwait, KUWAIT
PURPOSE
Antibiotics are routinely used after distal & mid shaft hypospadias repair; here in we evaluate the
necessity of its use by comparing the complication rate with and without antibiotic.
MATERIAL AND METHODS
A prospective-randomized study was conducted between (6/2014 & 9/2015). Patients with primary
distal & mid-shaft hypospadias were equally randomized into 2 groups, first group received post-
operative antibiotic until 2 days after catheter removal while the second group didn’t. All patients
received Antibiotic upon induction and underwent single stage Grafted Tubularized Incised Plate
repair (GTIP) by single surgeon. Operative steps & post-operative care were standardized using
the same sutures, dressing & catheter with drainage for 7 days. Urine analysis & culture were
done if symptomatic UTI was suspected. Both groups were compared as regard to early complica-
tion (symptomatic urinary tract infection, wound infection) and late complication (meatal stenosis,
urethral stricture, fistula, glans dehiscence). Follow up in clinic was scheduled at 10 days, 6 weeks,
3 & 6 months and yearly. Cases having medical conditions (DM, defective immunity and chronic
illness) were excluded.
RESULTS
A total of 86 patients were included, 43 in each group. Mean age at surgery was 2.4 years. The
mean follow up period was 1.8 years. Both groups were comparable as regard to patients’ age,
meatus location and chordee. No symptomatic UTI developed in either group. Total complication
rate was 6.9% (3 cases) in each group (Wound infection 1 patient in antibiotic group, 1 fistula
in antibiotic group and 2 in non-antibiotic, Urethral stricture 1 case in non-antibiotic group, Glans
dehiscence 1 case in antibiotic group). There was no difference in complication rate between both
groups.
CONCLUSIONS
Routine use of antibiotics post primary distal and mid penile hypospadias repair has no additional
role in reducing early & late complication rate.