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.
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