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ORIGINAL ARTICLE
Year : 2022  |  Volume : 20  |  Issue : 3  |  Page : 233-238

Comparative study between the closure of small-sized and medium-sized urethral cutaneous fistula after hypospadias repair with and without autologous platelet-rich plasma graft


Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University, Assiut, Egypt

Correspondence Address:
MBBCH Abdelrahman Elsayed Kopeya
Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University, Assiut
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/azmj.azmj_145_21

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Background and aim Many complications have been recorded after hypospadias repair surgeries. The most common one is the urethrocutaneous fistula (UCF). In this study, we aimed to compare the closure outcome of the small-sized and medium-sized UCF after hypospadias repair with and without autologs platelet-rich plasma (PRP) graft. Patients and methods This is a prospective comparative study for managing UCF in the pediatric age group of over 1 year. They were randomly divided into two groups: group A included 20 patients who underwent repair without PRP and group B included 20 patients who underwent repair with PRP. Complication rates were compared between the two groups. Results There was a significant difference in the occurrence of complications between the two groups. Recurrence of the fistula was observed in five cases, three (15%) in group A and two (10%) in group B. In group A, the three cases with fistula failed to be treated conservatively and needed another operation 6 months after the primary repair, while in group B, two cases were treated conservatively, and spontaneous closure of the fistula occurred while only one case required another operation for closure of the fistula. Postoperative infection was reported in two (10%) cases in group A and three (15%) cases in group B; they were treated using topical and systemic antibiotics. An extensive scar was reported in one case in group A. Conclusion Autologs PRP graft could be used in hypospadias surgeries and the repair of post-hypospadias repair UCF as it is safe, easily applicable, and proven its role in decreasing complications.


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