Bracka Repair in Proximal Hypospadias associated with severe chordee

Proximal hypospadias associated with severe chordee represents a major challenge for the surgeons and single-stage procedures are often associated with complications and reoperations. We studied the primary severe proximal hypospadias repaired with the Bracka two-stage procedure over a period of two years. Only primary proximal hypospadias associated with severe chordee were included in the study. Bracka two-stage repair was performed using free inner preputial graft in all cases. Second-stage was performed 6 months after the first-stage. Follow-up ranged from 9 months to 20 months. A total of 28 patients were included in the study. The age ranged from 2 years to 13 years with mean age of 3.4 years. In our study, the outcome was assessed in terms of fistula, meatal stenosis, glans dehiscence, stricture, diverticula formation and redo-urethroplasty. We concluded that in children with proximal hypospadias associated with severe chordee, Bracka two-stage repair is sound and reproducible technique with good outcome and minimal complications.