Modified Koyanagi's procedure for proximal hypospadias: Our experience

Nerli, Rajendra B; Santhoshi, Poonacha; Guntaka, Ajaykumar; Patil, Shital; Hiremath, Murigendra B

doi:10.1111/j.1442-2042.2010.02475.x

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…Complications, what so ever the technique used, were high and troublesome [ 6 ]. Because koyanagi technique used a parameatal vascularized flaps [ 7 ], it was first described as the technique to treat most sever, even perineal, hypospadias –contrary to duckett repair-with or without peno-scrotal transposition, in one stage [ 8 ]. Moreover, this technique lacked the circular anastomosis at the base of the urethroplasty which theoretically decreased the stenosis rate [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, this technique lacked the circular anastomosis at the base of the urethroplasty which theoretically decreased the stenosis rate [ 8 , 9 ]. In addition, using the koyanagi repair [7] , no bulking and no apparent penile torsion were noted [ 10 ]. Moreover, following this technique, there was always enough para -meatal tissues for the urethroplasty [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

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Two simple modifications can potentially change the future of proximal hypospadias surgery. Our series and a review of the literature

Akkary

Ripepi

Akokpe

et al. 2021

International Journal of Pediatrics and Adolescent Medicine

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Background/Objective To draw a hint towards two simple modifications that could potentially decrease the complication rate. Patients and Methods It was a single center, single operator and retrospective study. All patients with severe hypospadias operated according to koyanagi with or without modifications were presented. The surgical technique was described. Complications like fistula, stenosis, dehiscence and urethral diverticulum were studied. Results and Limitations Nineteen patients were included and presented in a chronological manner. The first four patients were operated according to the original koyanagi technique. The next 15 patients were operated according to koyanagi and the urethroplasty was covered by a tunica vaginalis flap. In 10 of them, glanduloplasty was done primarily and in the last 5 patients, glanduloplasty was done as a secondary procedure. The complication rates were 100% in the original koyanagi group, and 0% in the subset were glanduoplasty was deferred. Conclusions Systematically covering the urethroplasty with a tunica vaginalis flap and deferring the glanuloplasty might ameliorate the results of the koyanagi technique.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Two simple modifications can potentially change the future of proximal hypospadias surgery. Our series and a review of the literature

Akkary

Ripepi

Akokpe

et al. 2021

International Journal of Pediatrics and Adolescent Medicine

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“…They reported complications of meatal stenosis (16%), urethral-cutaneous fistula (39%), meatal recession (19%), and diverticulum (9%). Nerli et al (18) published their study in 2010, they worked on sample sized 14 patients, their age ranged from 3 to 9 years old. 28% of the patients had associated external genitalia anomaly.…”

Section: Discussionmentioning

confidence: 99%

New Modification of Koyanagi Technique Using Dartos Muscle Flap in Management of Proximal Hypospadias

Keshk

Sheikh

Rahman

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: One stage urethroplasty through parameatal foreskin flap (OUPF) available for all types of hypospadias was first described by Tomohiko Koyanagi (1983). High complication rates were reported. Objective: To evaluate the outcome of Koyanagi technique modification using dartos muscle as a 2 nd layer because it has a high vascularity, very thin, easily elevated, and leaves no complications. Patient and methods: This study was conducted in the Plastic Surgery Department at Menoufia University, during the period of April 2017 to April 2019. Thirty cases for proximal hypospadias were included during this study. After chordee release, urethra was constructed using Koyanagi technique and adding scrotal dartos muscle flap as a 2 nd layer. Results: Patient's age ranged from 1 to 4 years with mean age of 2.83 ± 1.17. All of the 30 cases were with proximal hypospadias and had severe chordee. Early complications were detected as bleeding in 2 patients (6.6%). One patient (3.3%) reported for retention due to obstruction of the inserted catheter. Another case (3.3%) showed wound infection. The reported late complications were fistula in 6 patients (20%), meatal recession in 5 patients (16.6%), meatal stenosis in 3 patients (10%), and diverticulum in one patient (3.3%). Conclusion:The modified Koyanagi one stage repair of proximal hypospadias is an innovative technique and realize many criteria for expected effective operating results. The use of dartos muscle flap as a cover for the urethroplasty improves the results and minimize complications.

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“…Hayashi et al [32] reported on 12 children treated with a modified neo-Koyanagi repair, with only one complication, a fistula. Nerli et al [33] reported on 14 children who had a repair using the modified Koyanagi method, with five complications, i.e. one dehiscence, three with fistula and one meatal stenosis.…”

Section: Discussionmentioning

confidence: 99%

Single- vs. multi-stage repair of proximal hypospadias: The dilemma continues

Badawy

Fahmy²

2013

Arab Journal of Urology

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IntroductionThe surgical reconstruction of distal penile hypospadias in a single stage is the standard practice for managing anterior hypospadias. Unfortunately, it is not simple to extrapolate the same principle to proximal hypospadias. There is no consensus among hypospadiologists about whether a single- or multi-stage operation is the optimal treatment for proximal hypospadias. In this review, we assess the currently reported outcomes and complications of both techniques in proximal hypospadias repair.MethodsWe searched Medline, Pubmed, Scopus and Ovid for publications in the last 10 years (2002–2012) for relevant articles, using the terms ‘proximal hypospadias’, ‘posterior hypospadias’ ‘single stage’, ‘multiple stage’, and ‘complications’. Articles retrieved were analysed according to the technique of repair, follow-up, complications, success rate, number of included children, and re-operative rate.Results and conclusionsThe reported complications in both techniques were similar, including mostly minor complications in the form of fistula, meatal stenosis, partial glans dehiscence, and urethral diverticulum, with their easy surgical repair. The outcomes of single- and multistage repairs of proximal hypospadias are comparable; no technique can be considered better than any other. Thus, it is more judicious for a hypospadiologist to master a few of these procedures to achieve the best results, regardless of the technique used.

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Modified Koyanagi's procedure for proximal hypospadias: Our experience

Cited by 7 publications

References 10 publications

Two simple modifications can potentially change the future of proximal hypospadias surgery. Our series and a review of the literature

Two simple modifications can potentially change the future of proximal hypospadias surgery. Our series and a review of the literature

New Modification of Koyanagi Technique Using Dartos Muscle Flap in Management of Proximal Hypospadias

Single- vs. multi-stage repair of proximal hypospadias: The dilemma continues

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