First experience with the use of fibrin glue in surgical treatment of hypospadias in children. Clinical study

Introduction. Hypospadias is one of the most common malformations of the external genital organs in boys. The development of surgical technologies in recent decades has significantly improved the functional and cosmetic results of hypospadias treatment. Nevertheless, complications of urethroplasty are still the most discussed issue of this problem. To prevent fistulas and urethral dehiscence, it has been proposed to cover the suture line with a single or double layer of dartos fascia from a de-epithelized foreskin. For a similar purpose, it has been also suggested using the fibrin glue to seal the sutures of the formed urethra. The objective of this study was to prospectively evaluate the efficacy of Evicel fibrin glue in the surgical treatment of distal hypospadias in children. Materials and methods. The study included 27 children under the age of 2 years (between 11 and 23 months) with coronary hypospadias. All children underwent tubularized incised plate surgery. The first group of patients comprised 11 (40.7%) children whose urethra was covered with Evicel fibrin glue after tubularization. Covering of urethra with two sheets of de-epithelized foreskin was performed in the second group, in 16 (59.3%) children. Results. We have not revealed statistical differences in the occurrence of complications in the studied groups of patients. In the first group, a fistula of the urethra was noted in 1 (9.1%) child, in the second group, 2 (12.5%) complications were revealed. Conclusion. From our perspective, the absence of differences in the complications rares in the studied groups of patients. We may conclude that the use of Evicel glue is as effective as covering the neourethra with a de-epithelialized foreskin flap.