A Thorough Analysis of The Effects and Complications of Two Different Suturing Techniques in Hypospadias Repair Using Tubularized-Incised Plate Urethroplasty: a Meta-Analysis.

Background: Hypospadias is a male congenital anomaly that requires urethroplasty via the tubularized-incised plate (TIP) technique. This technique is simple, and the results are promising, although it has few postoperative complications, including the associated suture technique. Objective: Comparing the continuous and interrupted suturing techniques on the TIP procedure for hypospadias repair. Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The authors thoroughly searched electronic databases of PubMed, Scopus, ScienceDirect, and Web of Science. The compared endpoints were the total complication, wound infection, meatal stenosis, glans dehiscence, and urethral stricture presented as risk ratio (RR), with mean operating time as mean difference (MD), in 95% confidence intervals (CIs). All statistical analyses were performed using Revman 5.4. Results: Ten eligible studies were included, totalling 1,894 patients. Pooled RR showed no significant difference in overall complication, surgical site infection, meatal stenosis, glans dehiscence, and urethral stricture between continuous and interrupted sutures. In subgroup analysis, the interrupted suture had fewer complications when using polyglactin material (RR: 1.51, 95% CI 1.07 to 2.14; p = 0.02). The continuous suture showed lesser mean operative time than the interrupted suture (MD: -6 .67, 95% CI -12.52 to -0.82; p = 0.03). Discussion and Conclusion: No significant complication difference existed between continuous and interrupted suturing techniques. Fewer complications were obtained when using interrupted sutures with polyglactin material. However, continuous suture required less mean operative time.

Prolapsed ureterocele mimicking a vulval mass in young female with complete duplex system and ureteral stone: A case report.

INTRODUCTION AND IMPORTANCE: Ureterocele is a congenital malformation of the ureter with dilatation in the distal part of the ureter. In most cases, this condition was present in childhood. In cases involving adults, this condition is associated with prolapse as well as the formation of stones. Prolapsed ureterocele with stone is considered to be a very rare case. We report a complex case of prolapsed ureterocele in a young female with a protruding mass in the vagina with complete pyeloureteral duplication and stone in the left ureterovesical junction. CASE PRESENTATION: A 19-year-old female presented to the hospital with a complaint of protruding mass in the vagina. A Computed Tomography (CT) scan and Intravenous Urography (IVU) confirmed the presence of a left ureterocele with a complete duplex system and stone in the ureterovesical junction. An endoscopic resection of the ureterocele was performed. One year following surgery, the patient was asymptomatic without deterioration of renal function or urinary tract infection. DISCUSSION: Prolapsed ureterocele in adulthood mimicking the clinical appearance of vulvar mass is considered a very rare case. The imaging examination in this case can be identified through CT-Scan. Surgical treatment of ureterocele consisted of incision, multiple punctures, unroofing, or resection. Considering the complex presentation in this case, we decided to undergo endoscopic resection to prevent the incidence of re-prolapsed which later required a second procedure. CONCLUSION: In cases of prolapsed ureterocele associated with urethral stones, endoscopic treatment is a viable option for reducing the risk of recurrent ureterocele prolapse.