Midterm outcome of the modified Bretteville technique for hypospadias reconstruction

Abstract

Hypospadias is a common condition affecting approximately one in 300 boys in Scotland. The functional and aesthetic outcome of the many different techniques of repair are being analysed in increasingly critical fashion. However, few techniques have been published with more than short-term follow-up data. The modified Bretteville technique is a two-stage technique that can be used for all degrees of severity of hypospadias. It has certain advantages over other single- and two-stage techniques. We present the midterm results of 74 hypospadias corrections performed by using the modified Bretteville technique. The majority of hypospadias were distal (93%), but the series includes patients with mid-shaft and proximal deformity. The mean follow-up period was 67 months (range: 5-126). The average number of procedures per patient was 2.35, and 78% of patients had only two procedures. The overall fistula rate was 5.4% and the stenosis rate was 6.8%, though this figure has fallen to 2.6% for the fistula rate (n=38) and 0% for the stenosis rate (n=38) over the most recent 5-year follow-up period. One patient needed re-repair using a Bracka technique. We believe that the modified Bretteville technique is a reliable technique for proximal, as well as distal, hypospadias with an excellent cosmetic outcome.