الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Despite the different surgical options for hypospadias repair, no technique is considered the golden standard. Hypospadias repair still remains a challanging condition for even the most talented surgeons.
However, the results of repair have evolved over time; there is still need for more easier and less invasive technique.
We conducted this study aiming to prove that the use of fibrin sealant is an easier, less invasive and effective in hyopspadias repaire. We enrolled 32 patients in our study. Their ages ranged from 2 to 21 years. Of the 32 candidates, 6 cases (19%) were subcoronal, 10 cases (31%) were distal penile,16 cases (50%) midpenile hypospadias. The cases were evenly distributed into 2 groups (group I were18 and group II were 14 each). The first group was managed by TIP technique using fibrin glue without dartos flap; the second group was managed by the ordinary TIP procedure using avascularized dartos flap. The distribution into these groups was random.
One of the most important exclusion criteria in this study was the sacrifice of the native urethral plate, any such case was omitted. Therefore, the preservation of the urethral plate was a necessity for inclusion.
Our follow up period extended throughout a 6 months period postoperatively.
group I results showed a 11% incidence of fistulation, 22% incidence of skin discoloration, 11% incidence of meatal stenosis, 63% incidence of mild infection that was controlled by medical treatment and 11% incidence of penile edema. The cosmetic outcome was satisfactory.
group II results showed a 43% incidence of fistulation, 64% incidence of skin discoloration, 21% incidence of meatal stenosis, 21% incidence of infection that was controlled by medical treatment and 43% incidence of penile edema. The cosmetic outcome was satisfactory.
The results were tabulated and statistically analyzed. There was statistical significance in the rate of complications between 2 groups. We notice that there is lower incidence of fistula in group I than the other group, also lower incidence of post operative penile edema and skin discoloration with group I. There was more incidence of infection with group I.
In this study, we noticed that the development of dartos flab in group II needs more dissection, more tissue trauma adding more difficulty to the procedure and more time is needed other than the group I. This meant that fibrin sealant application is an easier procedure, with less liability to skin ischemia and discoloration. It was also noticeable that the disadvantage of increased incidence of infection in group I is easily controlled conservatively and did not lead to more complications.
We also compared our results with the literature and previous studies. Our study showed similar results to most of the published data.
In future, we recommend that this study be extended to involve a bigger sample to provide us with ample results to signify such a comparison.
We also recommend it to be performed at a multicentre level to confirm our data. We recommend using biological glue as a sealant and healing promoter for hypospadias repair and we hope that more studies will appear in the future to confirm its efficacy in different surgical fields.