# The Outcome of Autologous Platelet-Rich Fibrin Membrane in Failed Distal Hypospadias Repair

## TL;DR

This study compares autologous PRF membrane and dartos flap for neourethral coverage in failed hypospadias repairs, finding PRF reduces complications.

## Contribution

Demonstrates autologous PRF membrane as a superior alternative to dartos flap for neourethral coverage in distal hypospadias repair.

## Key findings

- PRF group had lower reoperation rate (11.8%) compared to dartos group (28.1%).
- PRF group showed significantly fewer urethrocutaneous fistulas (2.9%) than dartos group (18.75%).

## Abstract

Failed distal hypospadias repair is considered a challenge due to the deficient scarred local penile tissue for tubularization and neourethral coverage in tubularized 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.

: 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 was 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.

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).

The autologous PRF membrane could be an effective neourethral coverage layer in comparison to local dartos flap in decreasing complications rate post failed distal hypospadias TIP repair.