Abstract:

Background: Hypospadias is one of the most challenging anomalies in the point of reconstruction. More than 600 techniques have been described in the literature until now. These techniques can be considered as either single or multiple staged. Every technique has some advantages and disadvantages. Although one stage techniques are mostly performed in primary hypospadias, there is no consensus in management of secondary hypospadias for “salvage” operations. More complication rates have beenreported in secondary cases. Material and methods: Between 1995 to 2000, we performed two stage hypospadias repair described by Bracka, in twelve patients who had history of two or more hypospadias repairs. Initially the patients were operated to create a bed for neo-urethra by a full thickness skin graft from retro-auricular region or buccal mucosa. Six months later, neo-urethra was created using this graft and the meatus was relocated to the anatomical region. To prevent fistula formation, waterproofing flap was performed to cover of neo-urethra. Results: Partial graft loss seen as secondary to infection was observed in one patient after the first operation and fistulas were seen in two patients after the second operation. Conclusions: These complication rates were lower than the reported salvage hypospadias repair techniques found in the literature. We concluded that two-stage hypospadias repair of Bracka is a good alternative in salvage hypospadias repair.

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