Parental Perceptions on Hypospadias Dressings on an Enhanced Patient Pathway

Abstract

Post-operative hypospadias dressings remain a challenging and variable issue of modern Hypospadias surgery. Besides giving compression, the dressing protects delicate repair, maintains an upright position, and holds stents in place. The dressing needs to be comfortable to the patient, easy to apply and remove, and easy to manage for parents at home without restricting the activity of the child. Standardising dressing and care simplifies processes for nursing staff and carers. With this in mind our units' Hypospadias Group has adopted a standardised dressing and care. Our unit utilises Double nappy technique; with an inner stent & dressing and outer nappy for soiling. Specialist Urology Nurse practitioner's role in supporting Parents after discharge is invaluable in dealing with any problems in a timely manner and preventing repeated hospital visits. We aimed to determine Parental Perception & Satisfaction on Post-operative Dressing care following Hypospadias surgery. 50 Parents of patients undergoing Hypospadias surgery were given a focused questionnaire immediately after removal of Dressing. The 5 point Likert scale questionnaire assessed parental comfort for Hypospadias dressing care and in the post-operative period (caring, cleaning and changing dressings at home). 49 Completed survey responses were collected. 80% of parents felt prepared for care of the post-operative dressings, with the majority (94%) having no concerns regarding the use of a double nappy. The majority of parents reported being comfortable or very comfortable in caring for the dressing at home (67%), cleaning around the dressing (63%) and nappy changes around the dressings (61%). The Parental perceptions of their child's comfort during the dressing removal showed more varied responses, however the majority of parents (86%) would not recommend any sedation for the dressing removal if given a choice. 96% of parents were satisfied with the functionality of the dressing, with 74% stating they were very satisfied. Advances and innovations of Hypospadias dressings may introduce new anxieties and demands on parents during the post-operative period of Hypospadias surgery. Peri-operative support of parents and families, and involvement of specialist nursing pathways can improve parental preparedness and satisfaction. We recommend a standardised technique for perioperative care.