OUTCOMES OF TRANSURETHRAL AND SUPRAPUBIC URINARY DIVERSION FOLLOWING HYPOSPADIAS REPAIR IN CHILDREN

Objective: to determine the outcomes and efficacy of transurethral urinary diversion/stenting with size six feeding tube and that of suprapubic cystostomy after hypospadias repair in children. methodology: an 8-year prospective experience at the university of benin teaching hospital on the outcomes of suprapubic urinary diversion (2000-2002) and transurethral diversion/stenting (2003-2007) after hypospadias repair in children. results: during the study period, a total of 196 children had urinary diversion following hypospadias repair, 69 (35.2%) suprapubic and 127 (64.8%) transurethral. they were aged between 6 months and 12 years. children who had transurethral diversion were relatively younger (mean age 2.3 ± 2.1 years) compared to suprapubic (3 ± 3.8 years). although anchorage to the glans penis and bed restriction in 115 (90.6%) children were required, urinary diversion was more effective, postoperative complications were rare, no trigone irritation, and excellent cosmetic results [121(95.3%)] were recorded following transurethral diversion with a size six feeding tube. conversely, the creation of suprapubic cystostomy increased operation and hospitalization duration with higher incidences of trigone irritation, 28 (4.6%), fistula formation, 18 (26.1%), catheter blockage, 10 (14.5%), soiling of operation site with urine and fewer number of children [48 (69.6%)] with excellent cosmetic results. conclusions: transurethral urinary diversion/stenting with a size six feeding tube was very effective and gave better results than suprapubic cystostomy. the feeding tube is cheap, readily available and may provide a better means of post hypospadias repair urinary diversion in children where an ideal transurethral paediatric catheter is not available.