The efficiency of two-stage technique for proximal hypospadias Proksimal hipospadias onariminda çift seansli Bracka tekniǧinin etkinliǧi


Kaçar M., ÇELİK F., SAĞLAM H., Balkan E., KILIÇ N.

Cocuk Cerrahisi Dergisi, vol.24, no.1, pp.18-23, 2010 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 24 Issue: 1
  • Publication Date: 2010
  • Journal Name: Cocuk Cerrahisi Dergisi
  • Journal Indexes: Scopus
  • Page Numbers: pp.18-23
  • Keywords: Bracka, Proximal hypospadias, Two-stage technique
  • Bursa Uludag University Affiliated: Yes

Abstract

Aim: The aim of this study was to review our series of the two-stage technique of Bracka for proximal hypospadias repair to evaluate postoperative complications, cosmetic and functional results. Material and Methods: Thirty eight patients were operated for proximal hypospadias between 2001-2010 in our department by using Bracka technique. Twenty five patients (65.8 %) had primary hypospadias and 13 patients (34.2 %) had previous unsuccessful surgeries. Mean age of the patients was 4.2 years (range 6 months-14 years). In the first stage a bed for neourethra created by a full-thickness skin graft without any subcutaneous fat (wolfe graft) from preputial inner mucosa or buccal mucosa. The second stage was done 6 months later. In the second stage the wolfe graft was tubularized around a catheter. Results: In the first stage after correction of the ventral chordee meatal locations were penoscrotal, scrotal and perineal in 24, 10 and 4 patients respectively. Nesbit procedure was performed in 12 patients (31.6 %) for correction of the chordee. The mean follow up of the patients was 1 year (1 month - 5,6 years). Nine patients (23.7%) showed different complications. Urethrocutaneous fistula (n:4, 10.5 %), glanular dehiscence (n:2, 5.3 %) and the distal urethral dehiscence (n:3, 7.9 %) were seen and fistula repair, glanuloplasty and urethroplasty was carried out. Following the repair of complications a total of 36 patients (94.7 %) had satisfactory cosmetic results with normal meatal position, normal glandular anatomy and normal cylindrical shafts without extra skin and chordee. Conclusions: Different complications can be seen at Bracka technique. But following the repair of complications, satisfactory functional and cosmetic results can be obtained.