Related Experiment Video
Updated: May 27, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Bracka's staged repair of proximal hypospadias--revisiting a versatile technique
Yew-Wei Tan1, Nakul Patel, Alexandra Scarlett
1Department of Paediatric Surgery, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK. ywtan80@doctors.net.uk
Objective:
Proximal hypospadias is associated with poorly defined urethral plate and often with chordee. A two-staged Bracka's repair is reproducible and has been used routinely in our practice. We present the key steps of this technique on a 13-month-old boy.
Patient And Method:
This boy presented with proximal penile hypospadias, hooded foreskin and mild chordee. He underwent stage one Bracka's repair. The steps included: 1) Artificial erection test to define extent of chordee; 2) inner preputial graft harvest and preparation; 3) glans and urethral plate incision down to corpora cavernosa; 4) partial release of chordee by division of aberrant corpus spongiosum, without degloving of penile skin; 5) laying of preputial graft; 6) dressing.
Result:
The patient had catheter removed on second, and dressing removed on seventh, post-operative days, without complication. The patient is planned for second stage repair in 6 months. Our standard approach includes either removal of catheter on the second or seventh post-operative day, according to surgeon preference. The three senior surgeons have used this method in 54 patients without significant complication. The graft has taken in 100% of cases.
Conclusion:
The Bracka's staged repair of proximal hypospadias is a versatile technique that gives reproducible and sound results.
