Abstract
Purpose: Proximal
hypospadias defects represent the most challenging of maintaining blood
supply to the flap, which eventually leads to a high rate of
complications. We modify a sealed Y-shaped penis foreskin vascular
protection technique, which can repair the urethra in a single stage.
Methods: Cut the inner plate of the foreskin along the coronal
sulcus, cut both sides of the urethral plate as deep as Buck’s fascia.
The ”Y”-shaped foreskin flaps on both sides of the mouth that are
continuous with the urethral plate are sutured to form a new urethral
skin tube. The urethral skin tube is turned to the ventral side, and the
foreskin is reshaped and sutured.
Results: A total of 89
children had their urinary catheters removed 4 weeks after the
operation. All children had reviewed at least once a year for 3
consecutive years. There are 11 patients with urine leakage, who
occurred after the operation. The children, diagnosed with urine
leakage, were successfully repaired after the leakage occurred one year
later at one time. There was no urethral stricture after an operation.
The one-time success rate of this operation was 87.6% (78/89) and the
incidence of the urethral fistula was 12.6% (11/89).
Conclusion: The results showed that sealed Y-shaped penis
foreskin vascular protection surgery had a safer and higher operation
rate than the traditional hypospadias repair technique.
Modifying the Koyanagi repair by our
improved Koyanagi hypospadias repair
is an excellent technique with relatively low complication rates.
Keywords: Koyanagi
technique,Y-shaped penis,surgery,Proximal hypospadias