Comparative Study of Polydioxanone and Polyglactin in Tubularized Incised Plate Urethroplasty for Hypospadias Repair

Abstract

Objective: To compare the postoperative outcomes of polyglactin (Vicryl) versus polydioxanone (PDS) sutures in tabularized incised plate (TIP) urethroplasty for mid-penile and distal hypospadias in children

Methodology: This prospective comparative observational study conducted in Department of Pediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from August 2025 to February 2026. A total of 110 male children aged 3–12 years with primary distal to mid-penile hypospadias were enrolled and divided into two equal groups such that one group underwent TIP urethroplasty using polyglactin (Vicryl) sutures whereas other group receivedTIP treatment using polydioxanone (PDS) sutures. Baseline characteristics were comparable between the groups. Postoperative outcomes including healing time, hospital stay, and complications such as urethrocutaneous fistula, bleeding, flap necrosis, glans dehiscence, hematoma, meatal stenosis, and infection were recorded and analyzed.

Results: PDS group showed significantly shorter healing time as compared to the Vicryl group (5.2 ± 2.0 vs 9.6 ± 3.5 days; p=0.032). No significant difference was observed in hospital stay between the two groups (p=0.512). Urethrocutaneous fistula was more frequent in the Vicryl group than the PDS group (16.3% vs 5.4%; p=0.042). Bleeding (3.6% vs 0%; p=0.04) and flap necrosis (7.2% vs 0%; p=0.003) were also significantly higher in the Vicryl group. No cases of meatal stenosis or postoperative infection were observed in either group.

Conclusion: Polydioxanone sutures are found to be associated with faster healing and a significantly lower rate of postoperative complications, particularly urethrocutaneous fistula, bleeding, and flap necrosis, compared to polyglactin sutures and should be preferred during TIP urethroplasty performed for mid-penile and distal hypospadias