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Duckett Versus Bracka Technique for Proximal Hypospadias Repair; A Single Centre Experience (Abstract)

K Fathi, AEE Burger, MS Kulkarni, AB Mathur

Department of Paediatric Surgery, Norfolk & Norwich University Hospital NHS Trust

United Kingdom



Backround: Repair of proximal hypospadias may fall into two categories – free graft as in Bracka’s technique, and vascularised flap as in Duckett’s. The aim of our study was to review the outcome and long-term follow up of proximal hypospadias repair using these two techniques.

Material and methods: Retrospective notes of patients undergoing hypospadias repair were reviewed. Between 1995–2006, 70 patients were identified of which 21 had primary repair of proximal hypospadias. Six patients had penoscrotal hypospadias, 2 proximal penile and 13 mid penile. Six boys had Duckett repair and 15 patients underwent Bracka procedure.

Results: The mean age of the patients was 28.8 months (range 16-52 months), with mean follow up of 33.9 months (range 2-84 months). Chordee was seen in 14 patients, 13 released and 1 corrected by dorsal Nesbit plication. Six of 21 (30%) boys developed meatal stenosis: 4 in Duckett and 2 in Bracka group which resolved by dilatation. All patients with Duckett repair had urethrocutaneous fistula, and none in Bracka group. Two boys with Duckett repair and one Bracka had redo surgery.

Conclusion: Our results suggest that Bracka repair creates a good outcome for proximal hypospadias repair, with significantly lower complication rates and good cosmetic outcomes than Duckett technique.

Key words: proximal hypospadias, two stage repair, fistula


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