Fistula formation after two staged Aivar Bracka’s repair for hypospadias.

Objectives: To evaluate the frequency of fistula formation after Bracka’s repair for hypospadias. Study Design: Retrospective Case study. Setting: Department of Plastic and Reconstructive Surgery, Shaikh Zayed hospital Lahore and Bahawal Victoria Hospital Bahawalpur. Period: 05 years (2014 -18). Material & Methods: Sixty patients of primary hypospadias underwent two staged Aivar Bracka’s repair. Age of patients, type of hypospadias, presence and extent of chordee, donor skin (preputial, post auricular) used, complications and fistula formation were recorded. Leakge of urine from repair site (Primary/Secondary) was noted as fistula formation after 03 weeks postoperatively. Results: A total of 60 patients underwent two staged Bracka’s repair. There were 32 patients (53.33%) with distal hypospadias, 16 patients (26.67%) with mid penile and 12 Patients (20%) with proximal hypospadias. Chordee was present in 33 Patients (55%). Prepucial skin was used in 46 Patients (76.66%) and post auricular skin in 14 Patients (23.34%) as a donor graft. Four patients (6.66%) developed fistula. 03 patients (5.00%) developed fistula at primary site and 01 patient (1.66%) developed at secondary site. Post auricular skin was used as a donor graft in all 04 patients developing fistula. Conclusion: Two staged Bracka’s repair is a versatile technique and reliable procedure for hypospadias repair with minimal complications and is applicable to all types of hypospadias due to excellent functional and cosmetic outcome.