Purpose of the study :

1. DOUBLE-TUBE STENTS DEVICE FOR NEO-URETHRA RECONSTRUCTION OF SEVERE TYPE OR RE-DO HYPOSPADIAS REPAIRJesun Lin 1, 2, Jian Ting Chen1, Herng-Jye Jiang1, Bai-fu Wang1, Ming-Chih Chou 21Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan2Institute of Medicine , Chung Shan Medical University, Taichung, Taiwan Purpose of the study : • Urine diversion and urethral stent are commonly used in the reconstruction of severe type and re-do hypospadias • Conventional methods of diversion : Bladder spasm and wound infection • Double-tube stents device : Intraurethral secretion and exudation are periodically cleansed by the voiding stream. Materials and Methods : • The procedures of the double-tube stents device: (Fig.1~Fig.3) • (1)The fine inner tube (from urethral meatus to the bladder) for temporal urine drainage • 5Fr. or 6Fr. in caliber that will minimize the bladder irritation • It will be removed within 48 hours after operation. • (2) The outer silicon bigger caliber (9Fr or 12Fr) fenestrated short tube for uretehra stent • From the meatus of the neo-urethra to distal end of the external sphincter • Anchored to the glans penis with a transfixing sututure of 5-0 Black silk • It will be maintained for about two weeks • (3)The patient may pass urine from the outer silicon tube after removing the inner fine tube (Fig.4) Results : • 36 patients (age 1-3 years old) were enrolled in this double-tube stents device in recent three years • All children were discharged on postoperative day three or four. • The most common complications were treated subsequently with uneventful results • (1) tube slipped off, 3 • (2) erosion of the glans penis, 2 • (3) urethral meatal stenosis, 2 • (4) urethro-cutaneous fistula, 3 Conclusion: • Advantage of the double-tube stents device • It could shorten the admission period • It could diminish the bladder spasm • The urination from the silicon fenestrated tube could periodically flush and cleanse the discharge of the urethra • It could minimize the infection of the urethra Fig. 1 Fig. 2 Fig. 3 Fig. 4