Use of platelet rich plasma gel in preventing healing complications of tubularised incised plate urethroplasty in children with distal and mid-penile hypospadias - A randomized clinical trial.

INTRODUCTION: Hypospadias is a common congenital disorder of the male external genitalia which is repaired surgically. Platelet rich plasma (PRP) gel formed by centrifugation of autologous blood has been shown to promote wound healing and has previously been used as a covering layer in hypospadias repair.

OBJECTIVE: Objective comparison of the occurrence of urethrocutaneous fistula and overall cosmetic appearance after PRP gel application on children with mid and distal penile hypospadias.

STUDY DESIGN: A two arm parallel design randomised controlled trial was performed on 50 children (age <14 years) with distal or mid penile hypospadias at a tertiary care centre in India from July 2024 to July 2025. We compared the patients who underwent Tubularised Incised Plate urethroplasty with PRP gel application (Study Group) to those who underwent standard tubularised incised plate urethroplasty (Control Group).

RESULTS: We noted a comparable preoperative Glans, Meatus and Shaft score between the groups (7.1 v/s 6.7, p = 0.25). Urethrocutaneous fistula had lower occurrence in the study group (8/25 v/s 12/25, p = 0.25). Post operative Hypospadias Objective Scoring Evaluation (HOSE) scores at 1 and 3 months were significantly different between the study and control groups respectively (14.4 v/s 12.6, p = 0.001; 14 v/s 11.7, p < 0.001) DISCUSSION & CONCLUSION: Utilization of platelet rich plasma gel in anterior hypospadias repair is safe and may have a role in reducing the occurrence of urethrocutaneous fistula and improving the overall cosmetic appearance. Its use may be extended to posterior hypospadias and compared to tissue flaps like tunica vaginalis in future studies.