Efficacy of PRF in Hypospadias Repair

August 10, 2026 updated by: Younan Ramsis, Ain Shams University

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

Not yet recruiting

Conditions

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

Interventional

Enrollment (Estimated)

80

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Younan R. Samir, M.D.
  • Phone Number: +201201255511
  • Email: dr_yona@live.com

Study Locations

  • Egypt
    • Abbasia
      • Cairo, Abbasia, Egypt, 11517
        • Ain Shams University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

No

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

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group A TIP urethroplasty with autologous PRF
Undergoes TIP urethroplasty with intraoperative placement of autologous PRF onto the urethral plate.
Procedure: Tubularized Incised Plate 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
Procedure: standard Tubularized Incised Plate urethroplasty

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

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

This is where you will find people and organizations involved with this study.

Sponsor

Ain Shams University

Investigators

  • Study Chair: Hany H. Gad, Professor, Ain Shams University
  • Study Director: Hossam M.H. ElAwady, Professor, Ain Shams University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

August 1, 2026

Primary Completion (Estimated)

August 1, 2027

Study Completion (Estimated)

October 1, 2027

Study Registration Dates

First Submitted

July 26, 2026

First Submitted That Met QC Criteria

August 10, 2026

First Posted (Actual)

August 11, 2026

Study Record Updates

Last Update Posted (Actual)

August 11, 2026

Last Update Submitted That Met QC Criteria

August 10, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PRF Hypospaias 001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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