Use of Acellular Dermal Matrix for Urethroplasty Coverage in Proximal Hypospadias Repair: a Pilot Study

Lin, Defu; Wang, Guannan; Song, Hongcheng; Qu, Yue; Liu, Pei; Liang, Huaping; Xu, Shuai; Chen, Shuofan; Zhang, Weiping; Zhao, Yannan; Chen, Bing; Sun, Ning

doi:10.1007/s12325-020-01254-9

Cited by 6 publications

(2 citation statements)

References 26 publications

(28 reference statements)

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“…In order to reduce the risk of fistula, we need a new replacement to cover the neourethra. Lin et al ( 26 ) used bovine skin-derived acellular dermal matrix as coverage in proximal hypospadias repair; their results showed a significantly reduced risk of fistula formation. According to the results of a randomized controlled trial, the use of AlloDerm ( 27 ), a human-derived freeze-dried acellular dermis, for hypospadias and fistula repair achieved good results.…”

Section: Discussionmentioning

confidence: 99%

Application of Allogeneic Human Acellular Dermal Matrix Reduces the Incidence of Fistula in Hypospadias Repair

Yang

et al. 2022

Front. Pediatr.

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BackgroundUrethrocutaneous fistula is one of the most common complications arising from hypospadias surgery. The purpose of our study was to investigate the effectiveness and safety of allogeneic human acellular dermal matrix (HADM) application as a means of preventing the occurrence of urethrocutaneous fistula following hypospadias surgery.MethodsThis is a non-randomized study of 219 cases (out of 270 patients with hypospadias) which satisfied inclusion and exclusion criteria. These patients were divided into two groups: 101 HADM patients, and 118 control patients (who did not receive HADM). In the control group, 77 boys were treated by single-stage urethroplasty (TIP) and 41 underwent staged urethroplasty (Thiersch-Duplay). In the HADM group, 59 boys underwent the TIP and 42 underwent the Thiersch-Duplay. In the postoperative period, we recorded the incidence of infection, urethrocutaneous fistula, and urethral stricture complications in these two groups of patients. The effectiveness and safety of HADM in preventing urethrocutaneous fistula following hypospadias surgery were evaluated according to these indicators.ResultsIn the control group, following the operation there were 16 cases of infection, 38 cases of urethrocutaneous fistula after extubating, and 5 cases of urethral stricture. In the HADM group, there were 19 cases of postoperative infection, 12 cases of urethrocutaneous fistula after extubating, and 5 children with urethral stricture. In comparing the two groups, it was found that the postoperative infection rate (13.6 vs. 18.8%) and the incidence of urethral stricture (4.2 vs. 5.0%) were not statistically significant (P > 0.05), while the postoperative urethrocutaneous fistula rate (32.2 vs. 11.9%) was statistically significant (P < 0.001).ConclusionIt is found that HADM application can significantly reduce the incidence of urethrocutaneous fistula complications, without increasing the risk of infection and urethral stricture.

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Section: Discussionmentioning

confidence: 99%

Application of Allogeneic Human Acellular Dermal Matrix Reduces the Incidence of Fistula in Hypospadias Repair

Yang

et al. 2022

Front. Pediatr.

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“…Recently, few studies have explored the relationship of tissue healing with postoperative complications in hypospadias repair. [ 5 6 ]…”

Section: Introductionmentioning

confidence: 99%

Effect of preoperative estrogen on complications after proximal hypospadias repair: A randomized controlled trial

et al. 2023

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Introduction: Proximal hypospadias repair has many postoperative complications such as urethrocutaneous fistulae, wound dehiscence, and urethral stricture. The beneficial effect of estrogen to promote wound healing has been known. We designed a study to determine whether preoperative stimulation of tissue with estrogen can reduce the postoperative complications associated with wound healing in patients undergoing hypospadias repair. Methods: Patients with proximal hypospadias requiring two-stage repairs (chordee correction followed by urethral tubularization) were randomized to estrogen and control groups before the second stage of surgery. In the former, topical estrogen cream (0.5 mg of estriol) was applied to the ventral penis for a month, whereas normal saline gel was applied to the latter; the urethroplasty was carried out thereafter. Patients were followed up for complications. Results: There were 29 patients in the estrogen group and 31 in the placebo group after the exclusion criteria were met. There was no significant difference in the overall postoperative complications between the estrogen group (44.8%) and the placebo group (51.6%). The occurrence of urethrocutaneous fistula (37.9% vs. 51.6%) and dehiscence (41.4% vs. 45.2%) was not significantly different between the estrogen and placebo groups. Neourethral stricture occurred in four patients in the estrogen group, while none of the patients in the placebo group developed stricture. Conclusions: The preoperative application of topical estrogen cream to the ventral penis failed to demonstrate any significant effect on wound healing and complications.

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The Use of Acellular Tissue Matrices in Gender‐Affirming Surgery: Review of the Literature and Institutional Experience

Alba,

Weinstein,

Arnold

et al. 2023

Advanced Biology

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Wound healing complications are not uncommon after genital gender‐affirming surgery and can pose significant challenges for the reconstructive surgeon. Acellular tissue matrices are products that contain extracellular matrix compounds without living cells and are used to expedite and improve wound healing. Some of these products have been described for a variety of different indications in gender‐affirming surgery. In this paper, the authors present a review of the current literature on the use of acellular tissue matrices in gender‐affirming surgery as well as the authors’ institutional experience in using these products.

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Use of Acellular Dermal Matrix for Urethroplasty Coverage in Proximal Hypospadias Repair: a Pilot Study

Cited by 6 publications

References 26 publications

Application of Allogeneic Human Acellular Dermal Matrix Reduces the Incidence of Fistula in Hypospadias Repair

Application of Allogeneic Human Acellular Dermal Matrix Reduces the Incidence of Fistula in Hypospadias Repair

Effect of preoperative estrogen on complications after proximal hypospadias repair: A randomized controlled trial

The Use of Acellular Tissue Matrices in Gender‐Affirming Surgery: Review of the Literature and Institutional Experience

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