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This study evaluates whether adding an autologous platelet-rich fibrin (PRF) membrane neourethral coverage layer improves outcomes after failed distal hypospadias TIP repair. Sixty-six recurrent patients were randomized to a dartos flap layer or an autologous PRF membrane and followed for 6–12 months for complications.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-outcome-of-autologous-platelet-rich-fibrin-membrane-in-failed-distal-hypospadias-repair/446234/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-outcome-of-autologous-platelet-rich-fibrin-membrane-in-failed-distal-hypospadias-repair/446234.png","ImageObject",300,407,{"name":92,"@type":93},"นรินทร์","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What problem does the study address in failed distal hypospadias repair?","Question",{"text":113,"@type":114},"Failed distal hypospadias repair is challenging due to deficient scarred local penile tissue that can limit tubularization and neourethral coverage in TIP repair, contributing to high complication rates.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were the patients assigned in the randomized study?",{"text":118,"@type":114},"Sixty-six recurrent distal hypospadias patients suitable for TIP repair were divided into two groups: Dartos flap coverage (group A, 32) and autologous PRF membrane coverage (group B, 34).",{"name":120,"@type":111,"acceptedAnswer":121},"What was the overall conclusion about the autologous PRF membrane?",{"text":122,"@type":114},"The autologous PRF membrane could be effective as a neourethral coverage layer, decreasing the postoperative complication rate compared with local dartos flap after failed distal hypospadias TIP repair.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},446234,1790774711,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},2336475104957,"https://ap-avatar.wpscdn.com/avatar/22000c4c6bd8a5076e1?x-image-process=image/resize,m_fixed,w_180,h_180&k=1787554080175789136","UROLOGY  \nRESEARCH & PRACTICE  \nORIGINAL ARTICLE Pediatric Urology  \nUrology Research and Practice 2025;51(5):189-195  \nDOI: 10.5152/tud.2025.25049  \nThe Outcome of Autologous Platelet-Rich Fibrin Membrane in Failed Distal Hypospadias Repair  \nABSTRACT  \nObjective: Failed distal hypospadias repair is considered a challenge due to the deficient scarred local penile tissue for tubularization and neourethral coverage in tubularized incised plate (TIP) repair and the high complications rate. To assess the additive effect of autologous platelet-rich fibrin (PRF) membrane neourethral coverage layer on failed distal hypospadias TIP repair outcomes.  \nMethods: A total of 66 recurrent distal hypospadias patients who were suitable for TIP repair were divided into group A: 32 patients in whom a local penile dartos flap layer was used and group B: 34 patients in whom an autologous PRF membrane was used. All patients were followed up for 6-12 months postoperatively for the presence of any complications.  \nResults: The reoperation rate in the Dartos group was more than twice that observed in the PRF group (28.1% vs. 11.8%; P = .11). Similarly, the rate of meatal stenosis (12.5% vs. 2.9%; P = . 18), infection (15 .6% vs. 8.8%; P = .46), and dehiscence (3 . 1% vs. 2.9%; P = 1.00) were all higher in the Dartos group. Urethrocutaneous fistula was reported in 7 patients, with 6 (18.75%) in group A and 1 (2.9%) in group B, showing a statistically significant difference (P \u003C .05) .  \nConclusion: The autologous PRF membrane could be an effective neourethral coverage layer in comparison to local dartos flap in decreasing complications rate post failed distal hypospadias TIP repair.  \nKeywords: Autologous platelet-rich fibrin, failed distal hypospadias repair, outcome  \nIntroduction  \nDifferent techniques for failed distal hypospadias have been utilized, with ongoing advancements and modifications emerging continuously. Tubularized incised plate (TIP) repair has achieved broad approval for the correction of failed distal hypospadias.1 The urethrocutaneous fistula (UCF) incidence ranges from 3% to 10% following primary hypospadias surgery.2  \nRisk of complications is twice as likely with a single failed hypospadias urethroplasty as it is with the first repair; the risk rises to 40% with 3 or more reoperations. This finding lends credence to the idea that penile tissue vascularity declines with each surgery and points to the necessity of therapies aimed at restoring vascularity.3  \nFistulas and other complications are significantly reduced when a protective barrier is placed between the neourethra and the skin. In order to avoid UCF, many second-layer covering layers have been detailed, which include either local penile subcutaneous tissue, tunica vaginalis, dartos, or extragenital tissues such as a free skin graft.4  \nThe use of local flaps is limited in recurring instances due to excessive scar formation and reduced blood supply to neighboring tissues. As a result, additional tissues with greater wound-healing properties must be used.2  \nCopyright @ Author(s)– Available online at [http://urologyresearchandpractice.org/](http://urologyresearchandpractice.org/)  \nContent of this journal is licensed under a Creative Commons Attribution (CC BY) 4.0 International License.  \nKhaled M. Abdelhalim Esam Abdelgawad Ahmed M. Kadry Mohamed Bakr Hassan Abdelwahab  \nDepartment of Urology, Suez Canal University Faculty of Medicine, Ismailia, Egypt  \nCorresponding author: Khaled M. Abdelhalim  \n􀀍 [drkhaledurology@gmail.com](drkhaledurology@gmail.com)  \n[Received:](Received: May 15)[ May 15](Received: May 15), 2025  \nRevision Requested: July 14, 2025  \nLast Revision Received: July 21, 2025  \nAccepted: August 13, 2025  \nPublication Date: December 5, 2025  \nCite this article as: Abdelhalim KM, Abdelgawad E, Kadry AM, Bakr M, Abdelwahab H. The outcome of autologous platelet-rich fibrin membrane in failed distal hypospadias repair. Urol Res Pract. 2025;51(5):189-195 .  \n","cbCaib0lYal8rs54","https://ap.wps.com/l/cbCaib0lYal8rs54","pdf",840875,"English","# Abstract\n# Introduction\n# Material and Methods\n## Patients’ Population\n# Results\n# Conclusion","[{\"question\":\"What problem does the study address in failed distal hypospadias repair?\",\"answer\":\"Failed distal hypospadias repair is challenging due to deficient scarred local penile tissue that can limit tubularization and neourethral coverage in TIP repair, contributing to high complication rates.\"},{\"question\":\"How were the patients assigned in the randomized study?\",\"answer\":\"Sixty-six recurrent distal hypospadias patients suitable for TIP repair were divided into two groups: Dartos flap coverage (group A, 32) and autologous PRF membrane coverage (group B, 34).\"},{\"question\":\"What was the overall conclusion about the autologous PRF membrane?\",\"answer\":\"The autologous PRF membrane could be effective as a neourethral coverage layer, decreasing the postoperative complication rate compared with local dartos flap after failed distal hypospadias TIP repair.\"}]","The Outcome of Autologous Platelet-Rich Fibrin Membrane in Failed Distal Hypospadias Repair | PDF",1790714530,18]