A comparative study between tubularized incised plate urethroplasty with and without fibrin glue

Abstract

Objective To compare the results of two single-stage hypospadias repairs, namely, tubularized incised plate (TIP) repair with and without fibrin glue as regards fistula formation, penile edema, wound infection, and cosmetic outcome. Background One of the most important factors in reducing the incidence of fistula and other complications is incorporation of an intermediate layer between the neourethra and the skin layer. It may be dartos fascia, tunica vaginalis, and others. The key step is using fibrin sealants as a protective covering layer. Patients and methods Between December 2014 and December 2016, we enrolled 32 male patients into our study at Menoufia University Hospital. The patients will be divided into two groups. The first group included about 18 patients where fibrin glue was applied after construction of a neourethra before closure of the skin. The second group consisted of about 14 patients who were treated by a construction of a neourethra but without the use of fibrin glue. Results The results of group I which underwent TIP urethroplasty with fibrin glue showed an 11% incidence of fistulation. Group II which underwent TIP urethroplasty without fibrin glue showed a 43% incidence of fistulation. Conclusion Applying a clot of fibrin glue between the layers of hypospadias repair will decrease the incidence of the complications after the repair. The fibrin glue results are poorer because of the increase in the rate of infection which will be the cause of fistula and wound dehiscence.