Duckett versus Modified Bracka Technique for Proximal Hypospadias Repair A 10-Year Experience

There are various techniques for treatment of proximal hypospadias disease.Surgical correction is often associated with complications. Proximal hypospadias can be repaired by Duckett or Bracka two-stage repair procedure. This study was to evaluate the outcomes, complications and long term follow-up of these two techniques in our referral hospital.
From January 2006 to January 2015 totally 1550 cases of hypospadias were diagnosed in our hospital, of which 164 patients with high type hypospadias underwent Duckett (78 cases) and modified Bracka (86 cases) surgical repair procedures. Sufficient data were analyzed for age at operation, type of pathology, chordee type, number of operations, complications, outcomes and follow-up.
One hundred sixty four cases with a mean age of 2.70 ± 2.6 (range 0.5 - 13) years underwent proximal hypospadias repair. Follow up ran in average to 5 (range 1 - 10) years.Chordee was seen in 19 (11.58%) cases which 15 (78.9%) cases released and 4 (21.1%) corrected by dorsal Nesbit plication. Fifteen of 164 (9.1%) cases had meatal stenosis: 5 in Bracka and 10 in Duckett group, all of which were repaired by dilatation. Six patients in Duckett group and only one in Bracka series had urethrocutaneous fistula. One case in Bracka group and five cases in Duckett series underwent re-operation.
Our study shows that proximal hypospadias repair with modified Bracka procedure has significantly a lower complication rate, also a better and more cosmetic outcome than Duckett technique.