Congenital Malformation of Urinary Tract in Infants and Children
A comparative analysis of Bracka and Duckett in the treatment of primary proximal hypospadias repair
Guan Yong, Meng Qingya, Wang Xin, Wu Yong, Guan Heyang
Published 2019-11-15
Cite as Chin J Urol, 2019,40(11): 821-824. DOI: 10.3760/cma.j.issn.1000-6702.2019.11.005
Abstract
ObjectiveTo compare the efficacy of Bracka method and Duckett method in the treatment of proximal hypospadias.
MethodsForty patients with hypospadias were treated by 2 stages(Bracka), 42 patients treated by transverse preputial island flap (Duckett) from January 2014 to January 2016. Mean age at first stage surgery were (19.70±6.62) months and (20.33±5.03) months in Bracka group and Duckett group, respectively. There were 10 cases of proximal penile type, 25 cases of penoscrotal type, 5 cases of perineal type in group 1. There were 11 cases of proximal penile type, 27 cases of penoscrotal type, 4 cases of perineal type in group 2. There was no significant difference in age and hypospadias classification between the two groups(P>0.05). All operations were performed by the same doctor. Urethral plate reconstruction with preputial graft was performed in group 1; stage Ⅱ Duplay urethroplasty repair was carried out 6-8 months after stage Ⅰ.
ResultsUrine tube was placed for 2 weeks after operation and followed up for 36-63 months(mean 47.6 months). After stage I repair, penile straightening and wide, smooth appearance of graft were confirmed. There was no fistula, split, urethral diverticulum or other complications, one case with urethral opening stenosis who was restored after urethral dilatation .After stage II repair, urethral fistula was noted in 3 cases(7.5%), stricture in 1 cases(2.5%). No other complications occurred . The total rate of complications was 10%(10/40). Urethral fistula was noted in 7 cases(16.7%), stricture in 3 cases(7.1%), penile head dehiscence in 3 cases(7.1%) and diverticulum in 1 case(2.4%) in group 2. The total rate of complications was 33.3%(14/42). The incidence of total complications between the two groups was statistically significant (P=0.011).
ConclusionsBracka method can be used to treat proximal hypospadias. It has high safety and low incidence of complications.
Key words:
Hypospadias; Proximal; Staged repair; Autograft repairt
Contributor Information
Guan Yong
Department of Urology, Tianjin Children's Hospital, Tianjin 300134, China
Meng Qingya
Department of Urology, Tianjin Children's Hospital, Tianjin 300134, China
Wang Xin
Department of Urology, Tianjin Children's Hospital, Tianjin 300134, China
Wu Yong
Department of Urology, Tianjin Children's Hospital, Tianjin 300134, China
Guan Heyang
Clinical Medicine, Chongqing Medical University, Chongqing 401331, China