A novel modification of HAYASHI-KOYANAGI repair for proximal hypospadias: preliminary report

Author:

Year-Number: 2022-36, No 1
Number of pages: 29-34
Mendeley EndNote Alıntı Yap

Abstract

OBJECTIVE: To report preliminary results of urethroplasty for proximal hypospadias by a novel modification of HAYASHI-KOYANAGI technique. MATERIALS AND METHODS: A total of 5 boys(5-11yrs), with penoscrotal hypospadias underwent urethroplasty over a period of one year (1st Oct’18 -30th Sept’19). The technique used, was essentially Hayashi- Koyanagi, with a modification. The modification consists of, excising an outer strip of skin, 5mm in breadth, all around the peri-meatal flap, without any dissection of the Dartos fascia; this facilitates the midline reconstruction of neo-urethral plate and then the tube formation over a stent. This policy of non-dissection causes minimal disturbance of already precarious blood supply of this long loop-shaped continuous flap. This neo-urethral tube is then covered by Tunica Vaginalis flap. All patients had suprapubic drainage for 2 weeks and urethral stents for 1week. RESULTS: No boys developed any fistula; one boy developed a sub-coronal diverticulum after 1.9yrs due to noncompliance with meatal dilatation; follow up ranges from 6m -2yr maximum. CONCLUSION: This novel technique will be an addition to the existing literatures of one-go urethroplasty methods, needing further evaluations by peers on a large scale with post-pubertal follow-ups.

Keywords

Abstract

OBJECTIVE: To report preliminary results of urethroplasty for proximal hypospadias by a novel modification of HAYASHI-KOYANAGI technique. MATERIALS AND METHODS: A total of 5 boys(5-11yrs), with penoscrotal hypospadias underwent urethroplasty over a period of one year (1st Oct’18 -30th Sept’19). The technique used, was essentially Hayashi- Koyanagi, with a modification. The modification consists of, excising an outer strip of skin, 5mm in breadth, all around the peri-meatal flap, without any dissection of the Dartos fascia; this facilitates the midline reconstruction of neo-urethral plate and then the tube formation over a stent. This policy of non-dissection causes minimal disturbance of already precarious blood supply of this long loop-shaped continuous flap. This neo-urethral tube is then covered by Tunica Vaginalis flap. All patients had suprapubic drainage for 2 weeks and urethral stents for 1week. RESULTS: No boys developed any fistula; one boy developed a sub-coronal diverticulum after 1.9yrs due to noncompliance with meatal dilatation; follow up ranges from 6m -2yr maximum. CONCLUSION: This novel technique will be an addition to the existing literatures of one-go urethroplasty methods, needing further evaluations by peers on a large scale with post-pubertal follow-ups.

Keywords