The Use of Autologous Platelet Rich Fibrin Membrane as a Second Layer in Snodgrass Repair of Distal Hypospadias

Abstract

Background: Hypospadias is a common pediatric health problem. Snodgrass [Tubularized Incised Plate Urethroplasty]surgical repair was adopted as the standard technique, although different techniques had been described. However, higher complication rate continues to be a problem. The aim of the work: To evaluate the use of platelet rich fibrin membrane as an intermediate layer in the Snodgrass repair of distal hypospadias. Patients and Methods: Thirty children were included. All were evaluated preoperatively by full history taking, clinical examination and laboratory investigations. Then all were treated by Tubularized Incised Plate Urethroplasty with the use of platelet rich fibrin membrane as an intermediate layer. They then followed up and any early or late complications were registered. Results: Hypospadias was recurrent among 83.3%. Patient age ranged between one and six years and the mean operative time was 67±5.4 minutes; the mean hospital stay duration was 7.0±1.2 days. The success rate was 93.3% and complication rate was 6.7%. Complications were edema in 6.7%, urethro-cutaneous fistula [UCF] in 6.7% and skin infection among 3.3%. Conclusion: The use of a platelet rich fibrin membrane is a feasible and safe intermediate layer for hypospadias surgery in Tubularized Incised Plate Urethroplasty. The procedure is quick and straightforward and has a low postoperative complication.

Keywords

• hypospadias
• snodgrass
• platelet-rich fibrin
• autologous
• intermediate