Khaled M. Abdelhalim, Esam Abdelgawad, Ahmed M. Kadry, Mohamed Bakr, Hassan Abdelwahab
Urology Research & Practice - 2025;51(5):189-195
Objective: Failed distal hypospadias repair is considered a challenge due to the defi- cient scarred local penile tissue for tubularization and neourethral coverage in tubular - ized incised plate (TIP) repair and the high complications rate. To assess the additive effect of autologous platelet-rich fibrin (PRF) membrane neourethral coverage layer on failed distal hypospadias TIP repair outcomes. Methods: A total of 66 recurrent distal hypospadias patients who were suitable for TIP repair were divided into group A: 32 patients in whom a local penile dartos flap layer were used and group B: 34 patients in whom an autologous PRF membrane was used. All patients were followed up for 6-12 months postoperatively for the presence of any complications. Results: The reoperation rate in the Dartos group was more than twice that observed in the PRF group (28.1% vs. 11.8%; P = .11). Similarly, the rate of meatal stenosis (12.5% vs. 2.9%; P = .18), infection (15.6% vs. 8.8%; P = .46), and dehiscence (3.1% vs. 2.9%; P = 1.00) were all higher in the Dartos group. Urethrocutaneous fistula was reported in 7 patients, with 6 (18.75%) in group A and 1 (2.9%) in group B, showing a statistically significant difference (P < .05). Conclusion: The autologous PRF membrane could be an effective neourethral cover - age layer in comparison to local dartos flap in decreasing complications rate post failed distal hypospadias TIP repair.
