Autologous platelet gel improves outcomes in tubularized incised plate repair of hypospadias

Elsayem, Karam; Darwish, Ahmed S; AbouZeid, Amr Abdelhamid; Kamel, Noha; Dahab, Mohamed M.; El-Naggar, Osama

doi:10.1016/j.jpedsurg.2021.03.058

Cited by 5 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The score ranges from 17 to 27. The study by Elsayem K et al [ 23 ] has the maximum score, and the study by Guinot A et al [ 16 ] has the least score. There is a very high, positive correlation between the variables rater 1 and rater 2 with r = 0.97.…”

Section: Resultsmentioning

confidence: 99%

“…APC can be obtained as a PRP membrane (sheet) with the addition of calcium chlorate to blood, as reported by Eryilmaz et al [ 21 ] and Mahmoud et al [ 22 ]. It can also be obtained as a platelet gel with the addition of calcium gluconate and thrombin to PRP as reported by Elsayem et al [ 23 ] to cover the neourethra. Guinot et al [ 16 ] obtained PRF, a second-generation platelet concentrate, by centrifuging blood at a lower speed.…”

Section: Discussionmentioning

confidence: 99%

“…There was no statistical heterogeneity observed between the included studies (I 2 = 0%) ( Figure 2 ). Among all four studies included for the pooled analysis, Elsayem K et al [ 23 ] used APC in re-do hypospadias repair also and other studies only in primary hypospadias repair. The subgroup analysis of these studies in which APC was used for the repair of primary hypospadias showed no statistically significant difference between two groups with RR-0.73 and CI 0.38, 1.40.…”

Section: Meta-analysis Of the Outcomementioning

confidence: 99%

“…In contrast,; the other studies did not report complications under the heading of total complication rate. When we added all the reported complications together to analyze the results, we observed that in the study by Elsayem K et al [ 23 ], the total reported complications outnumbered the total number of included patients, possibly due to multiple complications arising in a single patient. We have excluded this study from the analysis.…”

Section: Meta-analysis Of the Outcomementioning

confidence: 99%

“…Mean operative time was provided only by Mahmoud et al [ 22 ], who reported a shorter duration of surgery in the PRP group; however, the difference was not statistically significant. Elsayem K et al [ 23 ] have not specifically reported the mean operative time but mentioned that the mean operative time was more in the APC group. The rest two studies have not reported the mean operative time of the procedures.…”

Section: Meta-analysis Of the Outcomementioning

confidence: 99%

See 4 more Smart Citations

Use of an Autologous Platelet-Rich Concentrate in Hypospadias Repair: A Systematic Review and Meta analysis

Borkar

Tiwari

Mohanty

et al. 2022

Arab Journal of Urology

View full text Add to dashboard Cite

Background There is unanimous agreement amongst hypospadias surgeons to use an intermediate layer to cover the neourethra. Dartos fascia and tunica vaginalis (TV) flaps are the most preferred tissues to be used. Tissue glue, sealants and biomaterials are also useful where there is a paucity of local tissue to cover the neourethra. But these blood-derived products have associated infectious and allergic risks. The autologous human platelet concentrate (APC) contains biologically active factors and is safe for wound healing and soft tissue reconstruction. It has been used by few surgeons as an intermediate layer in hypospadias repair. This systematic review and meta-analysis aim to systematically compare the outcomes of hypospadias surgery in children with or without using APCs. Methods This systematic review and meta-analysis was conducted as per the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Meta-analysis protocol was registered with INPLASY. A systematic, detailed search was carried out by the authors in the electronic databases, including Medline, Embase, CENTRAL, Scopus, Google Scholar and clinical trial registry. Studies were selected and compared based on primary outcome measures like urethra-cutaneous fistula, meatal stenosis, wound infection and operative time. Statistical analysis was performed using a fixed-effect model, pooled risk ratio and I 2 heterogeneity. Results Four randomized studies with a total of 355 patients were included. Pooled analysis for outcome of urethra-cutaneous fistula (UCF) showed no significant difference between the groups with APC and without APC. Pooled analysis for the other outcome like meatal stenosis, wound infection and total complications showed a decrease in incidence of these complications in groups with APC. Conclusion This meta-analysis shows that there is a reduction in the incidence of wound infection, meatal stenosis and total complications in patients where APC was used to cover the neourethra, although no such difference was observed in UCF rates.

show abstract

Section: Resultsmentioning

confidence: 99%