The use of autologous platelet-rich fibrin membrane in hypospadias surgery: a preliminary study

Abstract

Background Hypospadias, a congenital anomaly with an incidence of 1/300, is a very challenging problem. Despite advances in hypospadias repair surgery, urethrocutaneous fistula remains a very common complication with a reported incidence varying from 4 to 28%. The use of an intermediate layer between the neourethra and the skin is one of the most important techniques used to reduce the likelihood of fistula formation and postoperative complications. Aim The aim of this study was to evaluate the effect of platelet-rich fibrin membrane (PRF) on the success rate of tubularized incised plate (TIP) repair and its postoperative complications. Patients and methods The study was carried out on 20 patients who were admitted to the Plastic and Reconstructive Surgery Department, Tanta University Hospitals, for hypospadias surgery throughout the period from the first of May 2015 to the end of April 2016. Urethroplasty was performed using the TIP technique. PRF membrane was applied and sutured over the sutured urethra as an intervening layer between the skin and neourethra. The perioperative course and postoperative complications were recorded. Results Twenty patients were included in this study. Their mean age at surgery was 2.45 years (range: 1–4 years). No intraoperative complications were encountered. Glanular edema occurred in two patients. Wound infection occurred in one patient. None of the patients had hematoma, wound dehiscence, or flap necrosis. With a mean follow-up of 6 months, urethral fistula occurred in two patients. Conclusion The PRF patch is a safe and efficient technique as an intermediate layer in TIP repair, and it helps to reduce the incidence of postoperative complications especially when healthy tissue is not available as an intervening layer.