COMPARISON OF OUTCOME OF AUTOLOGOUS PLATELET RICH PLASMA MEMBRANE PLUS DARTOS FLAP VERSUS SIMPLE DARTOS FLAP IN HYPOSPADIAS SURGERY

Abstract

Objective

To compare the outcome of the application of autologous platelet-rich plasma membrane layer and dartos fascial flap versus only dartos fascial flap in mid and distal penile hypospadias surgery.

Methods

This randomized controlled trial was conducted at Pediatric General surgical department, the Children’s hospital and the University of Child health, Lahore for the period of 12 months. Non probability, purposive sampling was used for data collection and randomization was done to assign the treatment. Total of 220 patients fulfilling the selection criteria were admitted after taking an informed consent. Cases were randomly divided into two groups A and B using random generator of Excel program. In group-A, dartos flap and PRP sheet layer was applied and in group-B, only a preputial dartos fascial flap was applied.

RESULTS

The mean age of all cases was 5.86 ± 3.10 years, while the mean age in group-A and group-B was 5.78 ± 3.13 years and 5.95 ± 3.08 respectively, with nonsignificant p-value > 0.05. The mean hospital stay was statistically same in group-A (6.67 ± 2.80 days) as compared to group-B (7.34 ± 2.79 days), p-value 0.08 (i.e. > 0.05). The mean time for Foleys removal was statistically same in group-A (9.31 ± 3.08 days) as compared to group-B (9.81 ± 2.81 days), p-value 0.21 (i.e. > 0.05).   In group- A and group-B, 32(29.1%) cases and 43(39.1%) cases had complications respectively (infection, urethrocutaneous fistula, glans dehiscence, Meatal stenosis). The complications rate was statistically same in both groups, p-value > 0.05.

CONCLUSION

It is concluded that patients who received dartos flap and PRP sheet coverage had less incidence of urethrocutaneous fistula as compared to cases received a preputial dartos flap only. Other complications were statistically same in both study groups.

Hence in future we can use PRP sheet coverage in addition to dartos flap for mid and distal penile hypospadias repair to achieve better outcomes and less fistula formation with good satisfaction.