Comparison of Polyglactin (Vicryl) Versus Polydioxanone (PDS) Suture in Sub-Coronal Hypospadias Repair in Terms of Urethrocutaneous Fistula Development

Vicryl vs PDS Sutures in Hypospadias Repair

Abstract

Background: Delayable absorbable sutures like polydioxanone may reduce urethrocutaneous fistula, but some surgeons warn that they could cause urethral stricture due to long-term tissue irritation. Various surgical techniques have evolved to manage this anomaly, but little research exists on the Pakistan Health sector's comparison of polyglactin (VICRYL) versus polydioxanone (PDS) sutures in pediatric hypospadias repair. Objective: The purpose of this study is to compare the Polyglactin (VICRYL) versus Polydioxanone (PDS) suture in hypospadias repair regarding the frequency of urethrocutaneous fistula development. Study Design: Randomized controlled trial. Settings: Department of Pediatric Surgery, Allied Hospital, Faisalabad Pakistan. Duration: 8^th July 2023 to 7^th July 2024. Methods: 150 male patients aged 1 to 5 years with sub-coronal hypospadias. Patients with previous hypospadias repair, pre-surgical testosterone stimulation, or other urogenital anomalies were excluded. Patients were divided into two groups: VICRYL (Polyglactin5/0 sutures) and PDS (Polydioxanone5/0 sutures) for urethroplasty. Postoperative assessment focused on the development of urethrocutaneous fistula, confirmed through clinical examination during follow-up. Results: In this study, urethrocutaneous fistula was found in 24.0% of patients in group V (Polyglactin (VICRYL)) and in 10.67% of patients in group P (Polydioxanone (PDS) suture) (p-value = 0.031). Conclusion: This study concluded that the frequency of urethrocutaneous fistula development is less with Polydioxanone suture in hypospadias repair as compared to Polyglactin suture.