Does glanular fixation suture affect surgical outcomes in distal hypospadias repair?

Purpose: This study aimed to evaluate the impact of glanular fixation suture on surgical outcomes in children undergoing distal hypospadias repair. Materials and methods: We retrospectively reviewed the data of 322 patients who underwent distal hypospadias repair in our clinic between January 2014 and December 2023. Patients operated on after January 2019, when the glanular fixation technique was adopted, formed the study group; those operated on before this date constituted the control group. All procedures were performed using the TIPU (tubularized incised plate urethroplasty) technique by the same pediatric urology team. Preoperative Glans-Meatus-Shaft (GMS) scores and six-month postoperative HOSE scores were used for comparison. Results: There was no statistically significant difference between the two groups regarding HOSE scores, fistula formation, or wound dehiscence (p>0.05). However, unintentional early dressing removal was significantly lower in the study group (2.4%) compared to the control group (11.4%) (p=0.02). Conclusion: While the application of a glanular fixation suture did not significantly affect overall surgical outcomes in distal hypospadias repair, it was associated with improved postoperative dressing adherence. This technique may offer an advantage in clinical protocols where dressing stability is crucial for optimal wound healing. Further prospective, randomized studies are needed to validate these findings.