Vol. 4 No. 1 (2026): January-March
54-59
2026-03-30
Open Access

Prevention of early wound complications in bladder neck reconstruction in children with bladder exstrophy using an autologous platelet-rich fibrin membrane

Z.B. Abdullaev
S.T. Agzamkhodzhaev
T.G. Aliyev
https://doi.org/10.63417/

Received: 2026-10-05

Published: 2026-03-30

PDF (Russian)
Crossmark Crossmark

Abstract

Background: Bladder neck reconstruction in children with bladder exstrophy carries a risk of early wound complications; an autologous platelet-rich fibrin (PRF) membrane may provide an additional biological covering of the suture line.


Objective: To evaluate the efficacy of additional coverage of the bladder neck reconstruction zone with an autologous PRF membrane for preventing early wound complications.


Materials and Methods: We followed 86 children with bladder exstrophy operated on at the National Children's Medical Center. A PRF membrane prepared from 5-10 mL of the child's own blood (centrifugation for 13-15 min at 3000 rpm) was placed over the bladder neck suture line in 15 children; 69 children were operated on without this coverage. Fisher's exact test, Spearman correlation, logistic regression, and ROC analysis were used.


Results: Complications occurred in 13.3% of children with PRF coverage and 43.5% without it (p = 0.039; OR 0.20; 95% CI 0.06-1.00). The membrane was the only significant protective factor (rho = -0.24; p = 0.029); pubic diastasis, bladder volume, and age showed no predictive value (AUC <= 0.56). The model reached an AUC of 0.66.


Conclusions: PRF membrane coverage significantly reduces early wound complications. The method is simple, autologous, inexpensive, and reproducible.

Keywords

List of references

  1. Aгзамходжаев С.Т., Абдуллаев З.Б., Алиев Т.Г., Пелих К.И., Ка-ганцов И.М. Экстрофия мочевого пузыря у детей: эволюция диагностики и современные тенденции хирургического лечения. Урологические ведомости. 2024;14(4):449–459.

  2. Morrill CC, Haffar A, Harris TGW, Crigger C, Gearhart JP. Current management of classic bladder exstrophy in the modern era. African Journal of Urology. 2023;29(1):27.

  3. Siregar S, Sibarani J, Prihatni D, Ciam A. Effect of bio-platelet rich fibrin as an adjuvant covering on post-operative complications after urethroplasty in proximal hypospadias. International Urology and Nephrology. 2026;58(6):2015–2023.

  4. Wishahy AMK, Abdullateef KSA, Kaddah SN, Mohamed AA, Mohamed MT. Surgical evaluation of autologous platelet-rich fibrin membrane as a coverage layer in repair of urethrocutaneous fistula after hypospadias surgeries: a randomized controlled trial. Journal of the Indian Association of Pediatric Surgeons. 2024;29(5):505–510.

  5. Elnashar AM, Albishbishy M, Sheir H, et al. Comparative study between autologous platelet-rich fibrin membrane and local flaps as intervening layer in management of distal hypospadias. Journal of Pediatric Surgery. 2025;60(1):161994.

  6. Ibrahim H, Abdelghany M, Yusuf A, Morsi H, Elshorbagy G. Can a platelet-rich plasma covering layer reduce urethrocutaneous fistula rate after distal penile hypospadias repair using the STAR technique? A randomized controlled trial. African Journal of Urology. 2025;31:55.

  7. Alsabri GA, van der Horst F, Alkaabi SA, et al. Evaluating growth-factor release in leukocyte- and platelet-rich fibrin, advanced platelet-rich fibrin, and injectable platelet-rich fibrin protocols: a narrative review. Growth Factors. 2024;42(4):216–228.

  8. Abdelazim O, Abdullateef KS, Khedr E, Tarek M. The use of an autologous platelet-rich fibrin membrane in urethroplasty for cases of distal hypospadias. Egyptian Pediatric Association Gazette. 2024;72(1):58.

  9. Jia K, You J, Zhu Y, et al. Platelet-rich fibrin as an autologous biomaterial for bone regeneration: mechanisms, applications, optimization. Frontiers in Bioengineering and Biotechnology. 2024;12.

  10. Narayanaswamy R, Patro BP, Jeyaraman N, et al. Evolution and clinical advances of platelet-rich fibrin in musculoskeletal regeneration. Bioengineering. 2023;10(1):58.

  11. Harris KT, Namdarian B, Gearhart JP, Wood D. Long term outcomes in classic bladder exstrophy: the adult picture. Journal of Pediatric Urology. 2024;20(2):157–164.

  12. The complete primary repair of bladder exstrophy: refinements through the Multi-Institutional Bladder Exstrophy Consortium (MIBEC). Journal of Pediatric Urology. 2022.

  13. Abdel-Khaleq EM, El Tagy G, El-Saket H, Abdel-Sattar AH, Fares AE. Assessment of the value of platelet-rich fibrin in the treatment of recurrent hypospadias cases in children: a comparative study. Egyptian Pediatric Association Gazette. 2026;74(1):17.

  14. Bi J, Larjava H, Ha¨kkinen L. Beyond the clot: how the biomolecular landscape of platelet-rich fibrin directs fibroblast functions. Frontiers in Oral Health. 2026;6:1731949.

About the Authors

Z.B. Abdullaev
info@hnchmc.uz
S.T. Agzamkhodzhaev
info@hnchmc.uz
T.G. Aliyev
info@hnchmc.uz

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Prevention of early wound complications in bladder neck reconstruction in children with bladder exstrophy using an autologous platelet-rich fibrin membrane. (2026). Herald of the National Children’s Medical Center, 4(1), 54-59. https://doi.org/10.63417/

Similar Articles

You may also start an advanced similarity search for this article.


ISSN 2181-3353 (Online)