Association of intraoperative platelet-rich fibrin (PRF) application with fistula and scar outcomes after hypospadias repair: A pilot randomized study.

Authors

Dilan Altıntaş Ural, Ali Erdal Karakaya, Ahmet Gökhan Güler

Published in

Journal of pediatric urology. Pages 106186. Aug 06, 2026. Epub Aug 06, 2026.

Abstract

Urethrocutaneous fistula and hypertrophic scar formation remain relevant concerns after hypospadias repair. Autologous biological adjuncts that may support local tissue healing have therefore gained interest in pediatric reconstructive surgery.
This pilot randomized, single-center study evaluated the potential association between intraoperative autologous platelet-rich fibrin (PRF) membrane interposition and early postoperative outcomes in children undergoing distal or mid-shaft hypospadias repair.
Twenty-two boys aged 6-72 months with previously untreated distal or mid-shaft hypospadias were randomized to PRF membrane interposition or control treatment with dartos coverage alone. All patients underwent standardized tubularized incised plate urethroplasty. PRF membranes were prepared intraoperatively using a low-speed centrifugation protocol and placed over the neourethral suture line in the intervention group. The primary outcome was urethrocutaneous fistula formation at 12 weeks. Secondary outcomes included Vancouver Scar Scale, Glans-Meatus Score, Hypospadias Objective Scoring Evaluation, wound infection, reoperation, and PRF-related adverse events.
No fistula occurred in the PRF group, whereas two fistulas were recorded in the control group (0% vs. 18.2%; p = 0.476). PRF application was associated with lower Vancouver Scar Scale scores (3.1 vs. 6.0; p < 0.001), higher Glans-Meatus Score values (10.8 vs. 8.9; p = 0.004), and higher Hypospadias Objective Scoring Evaluation scores (14.4 vs. 11.7; p = 0.002). No PRF-related technical complication or adverse event was observed. One wound infection occurred in the control group; however, the sample size was too small to support any inference regarding infection outcomes.
In this pilot randomized study, intraoperative autologous PRF membrane interposition was associated with more favorable early scar, cosmetic, and functional scores after distal and mid-shaft hypospadias repair. The absence of fistula in the PRF group may represent an exploratory clinical signal, but the low number of events and limited sample size preclude causal interpretation. Larger multicenter studies with longer follow-up are needed to clarify whether PRF has a durable role in reducing complications after hypospadias surgery.

PMID:
42642293
Bibliographic data and abstract were imported from PubMed on 26 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.