Use of fibrin sealant in hypospadias surgical repair reduces the frequency of postoperative complications.
BACKGROUND
Urethrocutaneous fistulas (UCF) and flap dehiscence (FD) are the most common postoperative complications after hypospadias (HS) surgical repair. The aim of this study was to evaluate whether the application of fibrin sealant over the site of surgery and suture lines reduces these complications.


METHODS
A prospective cohort of consecutive patients was treated over a 3-year period. 30 patients were submitted to HS surgical repair plus application of fibrin glue over the suture line and surgical site; for comparison, another 56 subjects made up the control group which was submitted to surgical repair only. Variables assessed included: age, type of HS, fibrin sealant used, complications and number of surgical procedures required to treat recurrences.


RESULTS
In general, the frequency of complications was 10 vs. 41% for UCF (p = 0.002), 13 vs. 50% for FD (p = 0.001), and for flap necrosis (FN) 6.7 vs. 28.6% (p = 0.01) for the treatment and control groups respectively. The number of surgical reinterventions to treat recurrences was higher in the control group than in the study group (p = 0.04).


CONCLUSIONS
The incidence of UCF after HS surgical repair can be reduced by applying fibrin sealant over the site of surgery and the suture lines.
Ambriz-González
Gabriela
G
Department of Pediatric Surgery, Pediatric Hospital, Guadalajara, Mexico. ggaby03@yahoo.com
Velázquez-Ramírez
Gabriela A
GA
García-González
José Luis
JL
de León-Gómez
José Manuel García
JM
Muciño-Hernández
María Ivette
MI
González-Ojeda
Alejandro
A
Basterra
Jaime Vargas
JV
D002675:Child, Preschool; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D015994:Incidence; D007223:Infant; D008297:Male; D008800:Mexico / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives