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