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Original Article

J Liaquat Uni Med Health Sci. 2013; 12(2): 98-102

Management and Outcome of Bracka’s Procedure on Penile Shaft Hypospadias

Adeel Hyder Arain, Javed Altaf, Nandlal Kella.

OBJECTIVES: To evaluate the outcome of Bracka’s procedure in patients with penile hypospadias.
MATERIAL AND METHODS: All the patients from urology, plastic surgery and Pediatric Surgery
Departments at LUHMS Jamshoro from October 2007 to September 2008 having penile shaft
hypospadias were included in this study. Patients who were above age 15 years, other congenital and already circumscribed penis were excluded from this study. Detailed examination of the
patients such as position and size of abnormal meatus, the presence of chordee, the quality and
width of urethral plate and the configuration of glans penis were noted. All the patients were
operated under general anesthesia. The surgical technique applied on the basis of stage 1 and
2. The data were entered and analyzed in Statistical Program SPSS version 16.0.
Results: Total number of 30 cases was included in this study. Twenty one (70%) patients had
the Distal Penile Hypospadias, 6(20%) had the Proximal penile and 3(10%) patients had mid
penile Hypospadias. Various post-operative Complications were noted, chordee 2(6.7%), lnfection 1( 3.3%), and loss of split thickness skin graft 1(3.3%), while after stage II, 2(6.7%) developed fistula formation and in 2(6.7%) developed edema. In this study the outcomes of Bracka’s
procedure include Voiding direction and meatal opening, 29 out of 30 patients had straight voiding direction and one patient had deviated voiding direction, similarly 29 out of 30 patients had
near normal meatal opening and one had abnormal meatal opening.
CONCLUSIONS: From our results we concluded that on the whole Bracka’s two stage technique
is simple, safe and versatile adjuvant to all types of hypospadias with minimal risk of complications and better out come.

Key words: Hypospadias, Bracka’s Procedure, Chordee

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