Efficacy of PRF in Hypospadias Repair
Evaluating the Efficacy of Platelet-Rich Fibrin (PRF) in Hypospadias Repair: A Randomized Controlled Trial
Hypospadias is an anomaly characterized by an ectopic ventral urethral meatus, and an incomplete or hooded prepuce. Its incidence is estimated at 1 in 200-300 live male births, with variations across populations and severity types.
Successful hypospadias repair depends largely on optimal tissue healing and robust vascular support around the neourethra. Thus, many adjunctive techniques have been investigated to improve outcomes, including dartos flaps, tunica vaginalis flaps, and various tissue sealants.
In recent years, attention has turned toward biological augmentation strategies, particularly the use of platelet-rich plasma (PRP) and platelet-rich fibrin as a potential enhancer of wound healing.
Platelet-rich fibrin (PRF), a second-generation autologous platelet concentrate, has recently emerged as another promising biologic in tissue engineering.
This study aims to evaluate the effect of PRF application in primary hypospadias repair surgery and determine its effect in improving healing and reduction of postoperative complications.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
All patients included in the study will undergo primary hypospadias repair using the standardized Tubularized Incised Plate (TIP) urethroplasty technique (Snodgrassi procedure), under general anesthesia and by the same surgical team to minimize variability
Steps of the Surgical Procedure (Same for Both Groups):
1. Preoperative preparation:
IV antibiotics, sterile field setup, general anesthesia. 2. Urethral plate incision and tubularization over a 6-8 Fr stent using absorbable sutures.
3. application of PRF (Group A only):
- 8-10 mL of autologous blood is drawn into plain (non-anticoagulant) tubes according to the patient's weight and the size of the patch needed.
- The sample is immediately centrifuged using the single-spin method (typically 3,000 rpm (400x g) for 12 minutes).
This produces three layers:
- Top layer: acellular plasma (PPP)
- Middle layer: platelet-rich fibrin (PRF) clot
- Bottom layer: red blood cells The PRF clot is gently removed and compressed using a gauze to form a thin PRF membrane.
PRF membrane is fixed on top of the suture line as a first layer and under the incision line as a second layer and secured using a few resorbable polyglyconate 6/0 interrupted sutures.
4. Glansplasty and skin closure using standard techniques in both groups 5. Catheter and dressing:
- A soft catheter is left in place for 5-7 days.
- A mild compression dressing is applied.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Mahmoud Mohamed Magdy El-Ansary, MSc
- Phone Number: +201114393349
- Email: mahmoudmagdy99@hotmail.com
Study Contact Backup
- Name: Younan R. Samir, M.D.
- Phone Number: +201201255511
- Email: dr_yona@live.com
Study Locations
-
-
Abbasia
-
Cairo, Abbasia, Egypt, 11517
- Ain Shams University
-
Contact:
- Younan R. Samir, M.D.
- Phone Number: +201201255511
- Email: dr_yona@live.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Diagnosed with primary distal or mid-penile hypospadias.
- Eligible for first-time (primary) surgical repair using the TIP (Tubularized Incised Plate) technique.
Exclusion Criteria:
- previous hypospadias surgery.
- Associated severe chordee requiring staged repair or patient with crippled hypospadias.
- Children with systemic diseases that may impair wound healing (e.g., diabetes, immunodeficiency, malnutrition).
- Presence of bleeding or coagulation disorders.
- Medically Unfit for surgery.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Group A TIP urethroplasty with autologous PRF
Undergoes TIP urethroplasty with intraoperative placement of autologous PRF onto the urethral plate.
|
Urethral plate incision and tubularization over a 6-8 Fr stent using absorbable sutures. Application of PRF where 8-10 mL of autologous blood is drawn into plain (non-anticoagulant) tubes and a thin PRF membrane is extracted which is fixed on top of the suture line as a first layer and under the incision line as a second layer and secured using a few resorbable polyglyconate 6/0 interrupted sutures. Glansplasty and skin closure using standard techniques and fixing catheter and dressing |
|
Active Comparator: Group B standard TIP urethroplasty without PRF
Undergoes standard TIP urethroplasty without PRF application
|
Urethral plate incision and tubularization over a 6-8 Fr stent using absorbable sutures. Glansplasty and skin closure using standard techniques and fixing catheter and dressing |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Urethrocutaneous fistula formation
Time Frame: 6 months
|
Incidence of urethrocutaneous fistula formation
|
6 months
|
|
Parental satisfaction Assessment
Time Frame: 6 months
|
Parental satisfaction assessed using a standardized questionnaire HOPE score
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Hany H. Gad, Professor, Ain Shams University
- Study Director: Hossam M.H. ElAwady, Professor, Ain Shams University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Urogenital Diseases
- Genital Diseases
- Genital Diseases, Male
- Male Urogenital Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Congenital Abnormalities
- Urogenital Abnormalities
- Penile Diseases
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
- Hypospadias
Other Study ID Numbers
Other Study ID Numbers
- PRF Hypospaias 001
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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