Purpose <p>To evaluate whether the double cannula urethral stents (DCUS) are superior to traditional silicone Foley catheters (FC) or gastric tubes (GT) in hypospadias repair to decrease complications.</p> Patients and methods <p>This retrospective cohort study included 224 patients with hypospadias who underwent placement with DCUS (group DCUS), FC (group FC), and GT (group GT) after hypospadias repair between August 2019 and June 2023. The occurrence of early and late complications was assessed. The occurrence of complications in the three groups was compared, and the important contributing factors of urinary fistula and glans dehiscence were determined.</p> Results <p>A total of 224 patients, 86 in FC, 59 in GT, and 79 in the DCUS group, met the inclusion criteria. Postoperative early complications in the DCUS group were significantly lower than those in the FC group (<i>P</i> = 0.002), but there was no significant difference between the GT and FC group (<i>P</i> = 0.390), or between the GT and DCUS group (<i>P</i> = 0.065). Postoperative late complications in the DCUS group were significantly lower than those in the FC group (<i>P</i> = 0.040), and there was no significant difference between the GT and FC group (<i>P</i> = 0.422), or between the GT and DCUS group (<i>P</i> = 0.325). Logistic regression showed that age (<i>p</i> = 0.030) and stent type (<i>p</i> = 0.048) were important risk factors for urethral fistula, while glans width (<i>p</i> = 0.016) was an important risk factor for glans dehiscence.</p> Conclusions <p>DCUS reduced the occurrence of complications compare to FC and GT after hypospadias repair, offering practical value for clinical application.</p>