title: Initial experience with 'inverted U' staged buccal mucosa graft (bracka) for hypospadias repair.
abstract: OBJECTIVE
  To describe a modification of the Bracka procedure ('inverted U'), used to enlarge the graft and diminish the risk of graft contracture compromising the subsequent urethral reconstruction.
  
  
  METHODS
  Inverted U Bracka procedure was performed in 10 children in whom previous hypospadias correction had failed. The surgical steps are identical to the original Bracka procedure. The only modification is reconfiguration to enlarge the graft.
  
  
  RESULTS
  Significant contraction of the graft was not seen in any patient and the second stage was performed uneventfully. After the second surgery there were two complications: one fistula and one wound infection.
  
  
  CONCLUSIONS
  In this preliminary study, the modification avoided significant contracture of the graft giving a more predictable size of the neourethra for the second-stage procedure. An amplified series is necessary to confirm this initial result.
authors.affiliation: Department of Urology, Federal University of Bahia, Bahiana School of Medicine and São rafael Hospital Roberto Santos General Hospital, Cidade Jardim, CEP: 40280620 Salvador, Bahia. ubarroso@uol.com.br
authors.forename: Ubirajara
authors.initials: U
authors.lastname: Barroso
authors.forename: Antonio
authors.initials: A
authors.lastname: Macedo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation*; D010413:Penis / Q000601:surgery; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation / Q000379:methods*; D014521:Urethra / Q000601:surgery; D013521:Urologic Surgical Procedures, Male / Q000379:methods*