Single-donor fibrin sealant for repair of urethrocutaneous fistulae following multiple hypospadias and epispadias repairs

Kajbafzadeh, Abdol‐Mohammad; Abolghasemi, Hassan; Eshghi, Peyman; Alizadeh, Farshid; Elmi, Azadeh; Shafaattalab, Saman; Dianat, SeyedSaeid; Amirizadeh, Naser; Mohseni, Mohammad Javad

doi:10.1016/j.jpurol.2010.06.004

Cited by 20 publications

(18 citation statements)

References 29 publications

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“…21 El-Galley et al showed that the concentration of epidermal growth factor is significantly lower in the foreskins of boys with hypospadias than in boys with a normal penis. 22 The rate of complications in group A with PRP coverage was less than group B with a significant difference (P = 0.040), also it was comparable with those reported in the literature for distal hypospadias repair, [11][12][13][14][15][16][17][18][19][20][21][22][23][24] indicating that this technique had no adverse effects.…”

Section: Discussionsupporting

confidence: 84%

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Autologous platelet‐rich plasma covering urethroplasty versus dartos flap in distal hypospadias repair: A prospective randomized study

et al. 2019

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Objective To compare the outcome and complication rate of the platelet‐rich plasma applied as a coverage layer and dartos flap layer during primary repair of distal hypospadias. Methods A prospective randomized study was carried out comprising 180 boys (age range 12–65 months) from October 2011 to December 2016 at Al‐Azhar University Hospitals, Cairo, Egypt. A single surgeon carried out all urethroplasty. Patients were randomly divided into two groups: group A (tubularized incised plate urethroplasty with platelet‐rich plasma coverage layer) and group B (ventral dartos flap). Complication rates were compared between two groups. Results There was a significant difference in the occurrence of complications between the two groups. A total of 36 (20%) complications were recorded in 26 patients, just 12 (13.3%) reported in group A, but 24 (26.7%) complications were reported in group B. Urethrocutaneous fistula was observed in nine patients (10%) in group A, and 12 (13.3%) in group B. Partial glans dehiscence occurred in one patient in group A, and four patients in group B. No patient in group A had a superficial wound infection, compared with six patients in group B. One case of meatal stenosis and urethral stricture was recorded in each group, all of which were managed conservatively. The resultant urinary stream was single and good in 154 patients of both groups. Conclusions Platelet‐rich plasma sheet might be considered as an alternative coverage layer for distal hypospadias repair, especially in the absence of a healthy layer.

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Section: Discussionsupporting

confidence: 84%

“…TIP repair is more versatile than other techniques, and has gained a widespread acceptance for hypospadias repair, especially for distal cases. Urethrocutaneous fistula remains a frequent complication after distal hypospadias surgery, the fistula rate varies from 3 to 10% …”

Section: Discussionmentioning

confidence: 99%

Autologous platelet‐rich plasma covering urethroplasty versus dartos flap in distal hypospadias repair: A prospective randomized study

et al. 2019

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“…Usually, the fistulous tract is circumscribed, dissected and closed to form the urethral layer by suture or sealant. 11 Local fascial tissue around the UCF, such as a de-epithelialized scrotal advancement flap, 3,4 a pure dartos flap or a tunica vaginalis flap, was transferred to form an effective vascularized waterproof barriers. [5][6][7][8] Then a preputial or scrotal flap was transferred to cover the cutaneous wound.…”

Section: Discussionmentioning

confidence: 99%

Three-layer reconstruction of large urethrocutaneous fistulas using scrotal-septal flaps

Zhou¹,

Lu²,

Zhou³

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(11-12):e828-31. http://dx.doi.org/10.5489/cuaj.1983 Published online November 24, 2014. AbstractIntroduction: The repair of large urethrocutaneous fistulas (UCFs) commonly involves reconstruction of the urethra, waterproof layer and skin coverage, which deploy different tissues from different flaps. To simplify the multiple procedures, we explored to use one flap (a scrotal-septal flap) to reconstruct three layers in UCF repairing in one stage. Methods: Between January 2011 and July 2012, 29 patients with large UCFs (ranging from 1.0 to 2.0 cm) were treated using scrotal-septal flaps for three-layer reconstruction. Every patient has an unbroken scrotum. The hair follicles in the donor site were destroyed using a radiosurgical knife 2 months before the operation. The flap was divided into three zones, which were flipped, folded, and extended respectively to form the urethra, waterproof layer and skin coverage. Results: The patients were followed up between 6 to 12 months. No fistula recurrence was observed. All flaps survived, except in one case, in which the distal skin flap was lost but stenosis or fistula did not develop. Two patients underwent second operations to refine the aesthetic results. Conclusions: The scrotal-septal flap can be transferred in an overturning-folding-advancement fashion and can simultaneously involve the reconstruction of the urethra, waterproof barrier and skin coverage. This is a simple and reliable alternative for large UCFs (≤2 cm) repairing at the penoscrotal junction; however, it cannot be used in patients with a damaged scrotal septum.

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“…Several local flaps and extragenital tissue grafts were used to interpose a waterproof layer between urethral and skin closures(4–7). Excessive scar formation and compromised blood supply of adjacent tissues limit the use of local flaps and necessitates the use of other supporting tissues with better wound healing features (9). Moreover, autologous or homologous fibrin materials are also used to provide a supporting layer over urethral repair.…”

Section: Discussionmentioning

confidence: 99%

“…However, they suggest that it does not eliminate the risk of UCF formation (8). Thereafter, Kajbafzadeh et al was proposed the use of single‐donor fibrin sealant for UCF repair (9).…”

Section: Introductionmentioning

confidence: 99%

Use of autologous platelet rich fibrin in urethracutaneous fistula repair: preliminary report

Soyer

Çakmak

Aslan

et al. 2012

International Wound Journal

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Urethrocutaneous fistula (UCF) is one of the most common complications occurring after hypospadias repair. Despite the surgical advancement in hypospadias, multiple failed fistula closures are commonly referred to paediatric urologists. Although several techniques have been described to interpose a waterproof layer between urethral and skin closures, occurrence of urethrocutaneous fistula cannot be eliminated completely. In addition to several local tissue grafts, autologous and homologous fibrin sealants are used to prevent UCF. Platelet rich fibrin (PRF) is known as an autologous source of growth factors obtained from the sera of the patient. PRF supports collagen synthesis and tissue repair and accelerates wound healing. We aimed to present our initial experience about the use of autologous PRF in a 3-year-old boy with a UCF after hypospadias repair.

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Single-donor fibrin sealant for repair of urethrocutaneous fistulae following multiple hypospadias and epispadias repairs

Cited by 20 publications

References 29 publications

Autologous platelet‐rich plasma covering urethroplasty versus dartos flap in distal hypospadias repair: A prospective randomized study

Autologous platelet‐rich plasma covering urethroplasty versus dartos flap in distal hypospadias repair: A prospective randomized study

Three-layer reconstruction of large urethrocutaneous fistulas using scrotal-septal flaps

Use of autologous platelet rich fibrin in urethracutaneous fistula repair: preliminary report

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