Comparison of Bracka I versus Blair-Byar’s technique in chordee correction.

Abstract

To compare the outcome of the Bracka I Graft Technique versus Blair-Byar’s Flap technique in orthoplasty for urethral plate in terms of procedure time, hospital stay and urine stream after removal of Foley catheter. Objectives: There are multiple types of procedures to correct the chordee in hypospadias with chordee cases. We planned to perform study to discuss the differences between Bracka I where Graft is used for the plate of urethra and Blair-Byar’s flap technique in term of procedure time hospital stay and urine stream after removal of Foley catheter. Study Design: Randomized Control Trial study. Setting: Pediatric Urology Department, Children Hospital Faisalabad (CHF). Period: 1 year and 9 months, from April 2016 to December 2018. Material & Methods: Total 80 patients were taken with Non probability consecutive sampling technique was adopted with inclusion criteria with more than 2 years of age and hypospadias with chordee while, exclusion criteria of patients were previous surgery of chordee correction and any other associated anomalies. Results: In the patients with Bracka I procedure, n=37 patients (92.5%)  have uneventful uptake of graft, where two (5%) patients have failure of uptake of graft while one (2.5%) of them had wound infection and adequate urinary stream after removal of Foley was found in all 40 patients. In Blair-Byar’s technique procedure had uneventful uptake of graft in n= 36 patients (90%) where two (5%) patients have failure of uptake of graft while two (5%) of them have wound infection. Cosmetically acceptance was in 39 patients (97.5%) by the parents and feasibility to do the second stage.  While among Blair-Byar’s technique cosmetically acceptance was in 35 patients (87.5%) by the parents and feasibility to do the second stage. Conclusion: Bracka I (graft) Orthoplasty and Blair-Byar’s (flap) Orthoplasty has equivocal results in terms of tissue uptake and uneventful recovery, urinary stream post operatively, post-operative meatal diameter while cosmetically Bracka 1 is superior to Blair-Byar’s  technique while feasibility of the availability of local tissue to make tube for urethroplasty in stage II.