Double neourethral covering with platelet-rich fibrin and Dartos flap versus double Dartos flaps in Tubularized Incised Plate repair of primary distal hypospadias | ||
| Egyptian Journal of Urology | ||
| Articles in Press, Accepted Manuscript, Available Online from 10 April 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/eju.2025.356588.1024 | ||
| Authors | ||
| Abdullah M Mansour* 1; Khaled Mahmoud Abdelhalim2; Mohamed Osama Abdalla3; Iman Yehia Ismail2; Ahmed M Alnashar2 | ||
| 1faculty of medicine, suez canal university. | ||
| 2Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. | ||
| 3Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. | ||
| Abstract | ||
| Background: Two-layer coverage with double Dartos flaps (DDF) was reported to give better protection against urethrocutaneous fistula (UCF) than single flap in Tubularized Incised Plate (TIP) urethroplasty. Platelet-rich fibrin (PRF) is a healing promotor and can be used as an autologous bioactive alternative to traditional tissue flaps. Objectives: To compare the effect of double covering of the neourethra with a single Dartos flap in addition to a PRF membrane versus DDF on rate of postoperative complications of TIP repair of primary distal hypospadias. Methods: A total of 44 patients with primary distal hypospadias were prospectively randomized into two groups according to the method of neourethral coverage. DDF technique was used in group A (included 22 patients with a mean age of 36±29 months). A single Dartos flap in addition to a PRF membrane were applied for group B (included 22 patients with a mean age of 30±21 months). PRF was intraoperatively prepared by simple centrifugation of a patientʼs blood sample. Results: After a minimum follow up for 6 months, group B showed better outcome and lower rate of UCF (4.5% compared to 13.6% in group A), although not statistically significant. Additionally, group B did not show any cases of wound infection versus 3 cases in group A. Conclusions: Two-layer neourethral coverage by a PRF membrane and a Dartos flap in TIP urethroplasty seems to decrease rates of postoperative UCF and wound infection compared to application of DDF. The technique is simple and safe. | ||
| Keywords | ||
| Double covering; platelet- rich fibrin; TIP repair; hypospadias | ||
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