Comparitive Study between Autologous Platelet-Rich Fibrin Membrane as A Second Layer Versus Dartos Flap in Complicated Hypospadias Cases in Pediatrics

Abstract

Background: Hypospadias, a common congenital anomaly, requires surgical intervention to enhance functional andaesthetic outcomes. Despite advancements, postoperative complications such as urethra-cutaneous fistula (UCF) andglans dehiscence remain prevalent.Objectives: This study compares its results with those of the conventional Dartos flap technique to assess the effectiveness of platelet-rich fibrin (PRF) membrane as a second layer covering in the healing of complicated hypospadias in pediatric male patients.Patients and methods: A total of 56 male patients, ranging in age from 6 months to 16 years old, were recruited andequally divided into two groups for a randomized controlled trial. Group A had a traditional Dartos flap covering, whereas group B used a PRF membrane.Results: Median age was 5.25 years (group A) and 3.17 years (group B). Group B showed significantly faster edemaresolution (3 vs. 4 days, P= 0.029) and reduced UCF incidence (3.6 vs. 21.4%, P= 0.043) and infection rates (3.6 vs.28.6%, P= 0.024). Operative time was shorter in group B (93.64 vs. 99.86min, P= 0.037).Conclusion: PRF membrane significantly enhances surgical outcomes in hypospadias repair by reducing the occurrenceof UCF and infection while minimizing operative time. PRF offers a promising alternative to conventional techniques,particularly in complicated cases.