Double neourethral covering with platelet-rich fibrin and Dartos flap versus double Dartos flaps in Tubularized Incised Plate repair of primary distal hypospadias
Mansour, A., Abdelhalim, K., Abdalla, M., Ismail, I., Alnashar, A. (2025). Double neourethral covering with platelet-rich fibrin and Dartos flap versus double Dartos flaps in Tubularized Incised Plate repair of primary distal hypospadias. EKB Journal Management System, (), -. doi: 10.21608/eju.2025.356588.1024
Abdullah M Mansour; Khaled Mahmoud Abdelhalim; Mohamed Osama Abdalla; Iman Yehia Ismail; Ahmed M Alnashar. "Double neourethral covering with platelet-rich fibrin and Dartos flap versus double Dartos flaps in Tubularized Incised Plate repair of primary distal hypospadias". EKB Journal Management System, , , 2025, -. doi: 10.21608/eju.2025.356588.1024
Mansour, A., Abdelhalim, K., Abdalla, M., Ismail, I., Alnashar, A. (2025). 'Double neourethral covering with platelet-rich fibrin and Dartos flap versus double Dartos flaps in Tubularized Incised Plate repair of primary distal hypospadias', EKB Journal Management System, (), pp. -. doi: 10.21608/eju.2025.356588.1024
Mansour, A., Abdelhalim, K., Abdalla, M., Ismail, I., Alnashar, A. Double neourethral covering with platelet-rich fibrin and Dartos flap versus double Dartos flaps in Tubularized Incised Plate repair of primary distal hypospadias. EKB Journal Management System, 2025; (): -. doi: 10.21608/eju.2025.356588.1024

Double neourethral covering with platelet-rich fibrin and Dartos flap versus double Dartos flaps in Tubularized Incised Plate repair of primary distal hypospadias

Egyptian Journal of Urology
Articles in Press, Accepted Manuscript, Available Online from 10 April 2025  XML
Document Type: Original Article
DOI: 10.21608/eju.2025.356588.1024
View on SCiNiTO View on SCiNiTO
Authors
Abdullah M Mansour email orcid 1; Khaled Mahmoud Abdelhalim2; Mohamed Osama Abdalla3; Iman Yehia Ismail2; Ahmed M Alnashar2
1faculty of medicine, suez canal university.
2Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
3Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Abstract
Background: Two-layer coverage with double Dartos flaps (DDF) was reported to give better protection against urethrocutaneous fistula (UCF) than single flap in Tubularized Incised Plate (TIP) urethroplasty. Platelet-rich fibrin (PRF) is a healing promotor and can be used as an autologous bioactive alternative to traditional tissue flaps.

Objectives: To compare the effect of double covering of the neourethra with a single Dartos flap in addition to a PRF membrane versus DDF on rate of postoperative complications of TIP repair of primary distal hypospadias.

Methods: A total of 44 patients with primary distal hypospadias were prospectively randomized into two groups according to the method of neourethral coverage. DDF technique was used in group A (included 22 patients with a mean age of 36±29 months). A single Dartos flap in addition to a PRF membrane were applied for group B (included 22 patients with a mean age of 30±21 months). PRF was intraoperatively prepared by simple centrifugation of a patientʼs blood sample.

Results: After a minimum follow up for 6 months, group B showed better outcome and lower rate of UCF (4.5% compared to 13.6% in group A), although not statistically significant. Additionally, group B did not show any cases of wound infection versus 3 cases in group A.

Conclusions: Two-layer neourethral coverage by a PRF membrane and a Dartos flap in TIP urethroplasty seems to decrease rates of postoperative UCF and wound infection compared to application of DDF. The technique is simple and safe.
Keywords
Double covering; platelet- rich fibrin; TIP repair; hypospadias
Statistics
Article View: 64