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Introduction <p>Urethrocutaneous fistula (UCF) is the most frequent complication after urethroplasty for proximal hypospadias, with reported rates up to 30%. Bio-Platelet Rich Fibrin (Bio-PRF), a novel autologous biomaterial enriched with growth factors, is hypothesized to enhance wound healing and reduce fistula formation when applied as an intermediate layer during urethral reconstruction.</p> Methods <p>This prospective study involved patients with proximal hypospadias undergoing urethroplasty at Hasan Sadikin General Hospital, Bandung, from September 2023 to December 2024. Subjects were divided into Bio-PRF group or control group (no Bio-PRF). The primary outcome was the incidence of UCF observed on 1st, 3rd, and 6th months. Baseline characteristics and outcome data were analyzed using the independent <i>T</i> test or Mann–Whitney U test, and chi-square test.</p> Results <p>A total of 36 patients were enrolled (18 in each group). Baseline characteristics, including age, hypospadias subtype, glans width, urethral plate dimensions, and laboratory parameters (hematologic, coagulation profiles, and albumin) were comparable. UCF incidence was higher in the Bio-PRF group (56.6% at 6th month) compared to controls though not statistically significant (<i>p</i> &gt; 0.05). There was no significant difference in other post-operative complication rate and operative time between both groups.</p> Conclusion <p>Bio-PRF application did not significantly reduce UCF rates and other complications after proximal hypospadias urethroplasty. Further studies are warranted to clarify the clinical value of Bio-PRF in pediatric reconstructive urology.</p>

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Effect of bio-platelet rich fibrin as an adjuvant covering did not decrease the incidence of post-operative complications after urethroplasty in proximal hypospadias

  • 期刊论文

  • 发表日期：

    2025年12月10日

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  • Safendra Siregar,
  • Jupiter Sibarani,
  • Delita Prihatni,
  • Albert Ciam

摘要

Introduction

Urethrocutaneous fistula (UCF) is the most frequent complication after urethroplasty for proximal hypospadias, with reported rates up to 30%. Bio-Platelet Rich Fibrin (Bio-PRF), a novel autologous biomaterial enriched with growth factors, is hypothesized to enhance wound healing and reduce fistula formation when applied as an intermediate layer during urethral reconstruction.

Methods

This prospective study involved patients with proximal hypospadias undergoing urethroplasty at Hasan Sadikin General Hospital, Bandung, from September 2023 to December 2024. Subjects were divided into Bio-PRF group or control group (no Bio-PRF). The primary outcome was the incidence of UCF observed on 1st, 3rd, and 6th months. Baseline characteristics and outcome data were analyzed using the independent T test or Mann–Whitney U test, and chi-square test.

Results

A total of 36 patients were enrolled (18 in each group). Baseline characteristics, including age, hypospadias subtype, glans width, urethral plate dimensions, and laboratory parameters (hematologic, coagulation profiles, and albumin) were comparable. UCF incidence was higher in the Bio-PRF group (56.6% at 6th month) compared to controls though not statistically significant (p > 0.05). There was no significant difference in other post-operative complication rate and operative time between both groups.

Conclusion

Bio-PRF application did not significantly reduce UCF rates and other complications after proximal hypospadias urethroplasty. Further studies are warranted to clarify the clinical value of Bio-PRF in pediatric reconstructive urology.