Comparison of Urethrocutaneous Fistula Formation in Continuous Versus Interrupted Suture Techniques in Tubularized Incised Plate Urethroplasty in Paediatric Patients: A Randomized Controlled Trial

Abstract

Objective: To compare the incidence of urethrocutaneous fistula following tubularized incised plate urethroplasty (TIPU) using continuous versus interrupted sub-epithelial suture techniques in pediatric patients.
Study Design: Randomized Controlled Trial study
Place and Duration of Study: This study was conducted at the Department of Paediatric Surgery, Allied Hospital, Faisalabad, from December 28, 2022 to June 27, 2023.
Methods: Eighty male children (ages 3–10) with distal hypospadias were enrolled through consecutive sampling and randomly assigned to continuous (Group A) or interrupted (Group B) subepithelial PDS 7/0 suturing. All surgeries were performed by a single consultant. Patients were hospitalized for 7 days with catheter removal on the final day. Follow-up was done at one week and one month post-discharge. Urethrocutaneous fistula formation was the primary outcome. Data were analyzed using SPSS v25 with Chi-square test and stratification; p ≤ 0.05 was considered significant.
Results: The frequency of urethrocutaneous fistula was 80% in Group A and 20% in Group B (p = 0.002).
Conclusion: Interrupted sub-epithelial suture technique in TIP urethroplasty showed a statistically significant trend toward fewer urethrocutaneous fistulas compared to the continuous method. These findings support further investigation in larger, multicenter trials to confirm clinical benefit.