ArticlePediatric surgery international2026
Graft width, catheter size, and intervention-requiring complications after two-stage bracka repair for proximal hypospadias: a retrospective cohort study.
Article in Pediatric surgery international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo characterize intervention-requiring complications after two-stage Bracka repair for proximal hypospadias and explore associations of recorded graft width and catheter size with stenosis.
methodsThis retrospective study included 49 children completing second-stage Bracka repair. The primary endpoint was a complication requiring dilatation, instrumentation, or unplanned surgery; hematoma and minor catheter displacement were reported separately. Graft width was defined as the shortest recorded first-stage graft dimension. Exploratory comparisons used graft width (< 12 vs. ≥12 mm), catheter size (6 vs. ≥8 Fr), and a post hoc 10-mm graft/≥8 Fr catheter configuration.
resultsIntervention-requiring complications occurred in 28/49 patients (57.1%): narrowing in 22 (44.9%), dilatation in 21 (42.9%), fistula in 14 (28.6%), and revision in 16 (32.7%). Stenosis occurred in 19/38 patients (50.0%) with graft width < 12 mm versus 3/11 (27.3%) with width ≥ 12 mm (p = 0.303), and in 19/38 (50.0%) with catheters ≥ 8 Fr versus 3/11 (27.3%) with 6 Fr catheters (p = 0.303). The post hoc combined configuration showed stenosis in 17/30 (56.7%) versus 5/19 patients (26.3%; OR 3.66, 95% CI 1.05-12.79; p = 0.045).
conclusionThis cohort had high stenosis-related morbidity. A recorded 10-mm graft combined with a catheter ≥ 8 Fr identified a subgroup with more stenosis in a post hoc, unadjusted analysis. This finding cannot establish a causal threshold but supports prospective graft and healed-plate measurement and avoidance of forced tubularization when available circumference is inadequate.
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