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

Soyer, Tutku; Çakmak, Murat; Aslan, Mustafa; Şenyücel, Mine; Kısa, Üçler

doi:10.1111/j.1742-481x.2012.00983.x

Cited by 18 publications

(3 citation statements)

References 13 publications

(26 reference statements)

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“…(16) Although one-stage repair is effective in certain cases with proximal hypospadias, (17,18) many surgeons still prefer a staged approach when moderate to severe chordee is present to obtain appropriate straightening and lengthening of the penis at the time of the first-stage surgery. (18)(19)(20)(21) Using a large series of hypospadias patients with marked chordae, we compare the results of a singlestage hypospadias treatment with those of a twostage hypospadias repair. Patients with hypospadias ranging from mild to severe were included in the study.…”

Section: Discussionmentioning

confidence: 99%

One stage versus two stage repair of hypospadias with marked chordae: a non randomized comparative study.

elmoghazy,

Wasel,

Hammady

et al. 2023

Sohag Medical Journal

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Purpose:The one-stage repair offers the benefit of utilizing skin that prior surgical operations have not damaged, has an intact blood supply and requires fewer hospitalization days, but it also depends on the surgeon's "expertise" and the family's preferences. Two-stage surgery is frequently preferred in severe primary proximal hypospadias or revision hypospadias. This study aimed to compare the surgical and functional outcomes of one-stage vs. two-stage hypospadias chordal repair. Methods: We conducted a comparative, non-randomized, prospective study on 60 patients with hypospadias with any degree of marked chordae. Patients were allocated to receive either one-stage or two-stage repair using onlay grafts and flaps. All patients were followed for one year postoperatively. The repair was completed six months later using the standard Thiersch-Duplay technique in those with a two-stage repair. Results: Thirty patients were managed in a two-stage procedure (28 with onlay preputial flap and two with buccal mucosal graft), while the remaining 30 patients were managed with a single-stage hypospadias repair with preputial skin flap (tabularized or onlay). The blood loss and operative time were significantly higher in the two-stage procedure group (p <0.05). The success rate of surgery in the one-stage group was 80%, while the two-stage group had a success rate of 83%, indicating a statistically insignificant difference between the two groups. The postoperative complication rate was 20% and 17% in the one-stage and two-stage groups, respectively. Conclusion:The one-stage correction is an effective surgical procedure for treating this condition, with short operative time and less blood loss without the need for a second stage.

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Section: Discussionmentioning

confidence: 99%

One stage versus two stage repair of hypospadias with marked chordae: a non randomized comparative study.

elmoghazy,

Wasel,

Hammady

et al. 2023

Sohag Medical Journal

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“…A follow-up study by this group demonstrated increased angiogenesis behind these improved outcomes [ 38 ]. Meanwhile, a case report described using platelet-rich fibrin—which generally contains a mix of TGF-B, VEGF, and EGF—placed directly on the urethra of a single pediatric patient who subsequently developed no fistula, an intriguing though far from conclusive report [ 39 ]. Overall, the impact of GFs on urethral healing demonstrates promise for future therapies, but prior to this study there has been no opportunity to compare the impact between GFs.…”

Section: Discussionmentioning

confidence: 99%

Development of a Wound-Healing Protocol for In Vitro Evaluation of Urothelial Cell Growth

Foster

Jensen

Finck

et al. 2023

MPs

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Urethral healing is plagued by strictures, impacting quality of life and medical costs. Various growth factors (GFs) have shown promise as therapeutic approaches to improve healing, but there is no protocol for in vitro comparison between GFs. This study focuses the development of a biomimetic in vitro urothelial healing assay designed to mimic early in vivo healing, followed by an evaluation of urothelial cell growth in response to GFs. Methods: Wound-healing assays were developed with human urothelial cells and used to compared six GFs (EGF, FGF-2, IGF-1, PDGF, TGF-β1, and VEGF) at three concentrations (1 ng/mL, 10 ng/mL, and 100 ng/mL) over a 48 h period. A commercial GF-containing medium (EGF, TGF-α, KGF, and Extract P) and a GF-free medium were used as controls. Results: There was a statistically significant increase in cell growth for IGF-1 at 10 and 100 ng/mL compared to both controls (p < 0.05). There was a statistically significant increase in cell growth for EGF at all concentrations compared to the GF-free medium control (p < 0.05). Conclusion: This study shows the development of a clinically relevant wound-healing assay to evaluate urothelial cell growth. It is the first to compare GFs for future use in reconstructive techniques to improve urethral healing.

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“…Autologous platelet concentrate (APC) is a safe product for wound healing, soft tissue reconstruction and bone healing [ 13 , 14 ]. It was first used in hypospadias surgery for the closure of UCF by Soyer et al [ 15 ]. Guinot A et al [ 16 ] was the first to use an autologous platelet-rich fibrin membrane for urethroplasty coverage with encouraging results.…”

Section: Introductionmentioning

confidence: 99%

Use of an Autologous Platelet-Rich Concentrate in Hypospadias Repair: A Systematic Review and Meta analysis

Borkar

Tiwari

Mohanty

et al. 2022

Arab Journal of Urology

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Background There is unanimous agreement amongst hypospadias surgeons to use an intermediate layer to cover the neourethra. Dartos fascia and tunica vaginalis (TV) flaps are the most preferred tissues to be used. Tissue glue, sealants and biomaterials are also useful where there is a paucity of local tissue to cover the neourethra. But these blood-derived products have associated infectious and allergic risks. The autologous human platelet concentrate (APC) contains biologically active factors and is safe for wound healing and soft tissue reconstruction. It has been used by few surgeons as an intermediate layer in hypospadias repair. This systematic review and meta-analysis aim to systematically compare the outcomes of hypospadias surgery in children with or without using APCs. Methods This systematic review and meta-analysis was conducted as per the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Meta-analysis protocol was registered with INPLASY. A systematic, detailed search was carried out by the authors in the electronic databases, including Medline, Embase, CENTRAL, Scopus, Google Scholar and clinical trial registry. Studies were selected and compared based on primary outcome measures like urethra-cutaneous fistula, meatal stenosis, wound infection and operative time. Statistical analysis was performed using a fixed-effect model, pooled risk ratio and I 2 heterogeneity. Results Four randomized studies with a total of 355 patients were included. Pooled analysis for outcome of urethra-cutaneous fistula (UCF) showed no significant difference between the groups with APC and without APC. Pooled analysis for the other outcome like meatal stenosis, wound infection and total complications showed a decrease in incidence of these complications in groups with APC. Conclusion This meta-analysis shows that there is a reduction in the incidence of wound infection, meatal stenosis and total complications in patients where APC was used to cover the neourethra, although no such difference was observed in UCF rates.

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

Cited by 18 publications

References 13 publications

One stage versus two stage repair of hypospadias with marked chordae: a non randomized comparative study.

One stage versus two stage repair of hypospadias with marked chordae: a non randomized comparative study.

Development of a Wound-Healing Protocol for In Vitro Evaluation of Urothelial Cell Growth

Use of an Autologous Platelet-Rich Concentrate in Hypospadias Repair: A Systematic Review and Meta analysis

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