Urological Applications of Novel Hyaluronic Acid/Alginate Gel to Protect Nerves: A Single-Surgeon Experience.

Abstract

Background Tissue gliding and mobility are crucial for the success of penile procedures, as postoperative adhesions can lead to painful tethering of tissues, including nerves. While most commercially available options are not designed to reduce friction and/or often have inconsistent bioresorption, a novel hyaluronic acid/alginate hydrogel represents a significant advancement in reducing postoperative tissue adhesions. This study aimed to evaluate its intra-operative application in pediatric and adult urologic surgeries with associated indications and postoperative outcomes (re-admission, re-operation, complications). Methods A retrospective review of 142 male patients undergoing urologic procedures by a single surgeon between October 1, 2022, and October 1, 2023, was conducted after IRB approval. The hydrogel was applied intra-operatively at the surgical site prior to closure. Data on demographics, preoperative diagnoses, and postoperative outcomes were extracted from a prospectively maintained registry and verified through chart review. Diagnoses included 376 conditions such as penoscrotal webbing, hidden penis, and phimosis. Outcomes, including complications, readmissions, and reoperations, were evaluated over an eight-week follow-up period. Descriptive statistics summarized the data and visual tools were used for analysis. Results The cohort comprised 142 male patients, predominantly pediatric (93.7%), with the majority (60.0%) under 1 year of age. A total of 376 urologic diagnoses were recorded, with the most frequent being penoscrotal webbing (94 cases, 25.0%), hidden penis (73 cases, 19.4%), and phimosis of the penis (61 cases, 16.2%). Less common diagnoses included hypospadias (6 cases, 1.6%) and various rare conditions with a frequency of 0.27%. Postoperative outcomes showed no complications, re-admissions, or re-operations among the entire patient cohort. Conclusion Intra-operative application of a hyaluronic acid/alginate hydrogel in pediatric and adult urologic procedures demonstrates its safety and potential utility in minimizing postoperative tissue adhesions and complications. Further study is warranted to confirm these findings and explore additional applications of this material.