Frequency of Late Complications After Two Staged Aivar Bracka(AB) Repair of Hypospadias

Hypospadias is a congenital anomaly in which due to the incomplete fusion of urethral folds the meatus opens on the ventral surface of the penis. It is the most common congenital malformation of the urethra with the prevalence of 1 in 200-300 live male births. The late complications of two stage AB repair of hypospadias are Urethrocutaneous fistula formation, urethral strictures, meatal stenosis and persistent chordee which occur within 6 weeks after the 2nd stage of the procedure. The aim of the study is to determine the frequency of late complications of two staged AB repair. The rationale of the study is that if the late complications rate of two staged AB repair comes out significantly lower than other studies then it will help reconsider the existing guidelines of hypospadias surgery. Material and methods This study was conducted at Plastic and reconstructive unit Hayatabad Medical Complex Peshawar for the period of 24 months (from August 2011 to July 2013). The total sample size was 370 patients. More over this was a descriptive cross-sectional study in which non-probability consecutive sampling technique was used. Results In this study mean age was 3 years with standard deviation ± 1.24. All the patients were male in which 28% patients had Urethrocutaneous fistula, 8% patients had urethral structure. Frequency of complications among 370 patients was analyzed as late complications n=104(28%) patients had Urethrocutaneous fistula, n=30(8%) patients had urethral stricture, n=44(12%) patients had meatal stenosis and n=19(5%) patients had persistent chordee. Conclusion The most common late complication is Urethrocutaneous fistula and it can be reduced by adding a water proofing layer over the urethroplasty, keeping the suture line of subsequent layers eccentric and meticulous tissue handling under loupe magnification.