Efficacy of PRF in Hypospadias Repair

All patients included in the study will undergo primary hypospadias repair using the standardized Tubularized Incised Plate (TIP) urethroplasty technique (Snodgrassi procedure), under general anesthesia and by the same surgical team to minimize variability

• Steps of the Surgical Procedure (Same for Both Groups):

• Preoperative preparation:
• IV antibiotics, sterile field setup, general anesthesia. 2. Urethral plate incision and tubularization over a 6-8 Fr stent using absorbable sutures.

• application of PRF (Group A only):
• 8-10 mL of autologous blood is drawn into plain (non-anticoagulant) tubes according to the patient's weight and the size of the patch needed.
• The sample is immediately centrifuged using the single-spin method (typically 3,000 rpm (400x g) for 12 minutes).
• This produces three layers:

• Top layer: acellular plasma (PPP)
• Middle layer: platelet-rich fibrin (PRF) clot
• Bottom layer: red blood cells The PRF clot is gently removed and compressed using a gauze to form a thin PRF membrane.
• PRF membrane is fixed on top of the suture line as a first layer and under the incision line as a second layer and secured using a few resorbable polyglyconate 6/0 interrupted sutures.

• Glansplasty and skin closure using standard techniques in both groups 5. Catheter and dressing:
• A soft catheter is left in place for 5-7 days.
• A mild compression dressing is applied.

Inclusion criteria

• Diagnosed with primary distal or mid-penile hypospadias.
• Eligible for first-time (primary) surgical repair using the TIP (Tubularized Incised Plate) technique.

Exclusion criteria

• previous hypospadias surgery.
• Associated severe chordee requiring staged repair or patient with crippled hypospadias.
• Children with systemic diseases that may impair wound healing (e.g., diabetes, immunodeficiency, malnutrition).
• Presence of bleeding or coagulation disorders.
• Medically Unfit for surgery.