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178612

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

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Last updated: 24 Dec 2024

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Abstract

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 2nd 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 2nd 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.    

DOI

10.21608/ejhm.2021.178612

Keywords

Dartos muscle flap, Management, Modification of Koyanagi, Proximal Hypospadias

Authors

First Name

Tarek Abd El Hamed

Last Name

Keshk

MiddleName

-

Affiliation

Plastic Surgery Department, Faculty of Medicine Menoufia University, Menoufia, Egypt

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Orcid

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First Name

Yasser Mohamed Omar

Last Name

El Sheikh

MiddleName

-

Affiliation

Plastic Surgery Department, Faculty of Medicine Menoufia University, Menoufia, Egypt

Email

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City

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Orcid

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First Name

Mahmoud

Last Name

Abd El Rahman

MiddleName

-

Affiliation

Plastic Surgery Department, Faculty of Medicine Menoufia University, Menoufia, Egypt

Email

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City

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Orcid

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First Name

Hanan Ali Ali

Last Name

Dawod

MiddleName

-

Affiliation

Plastic Surgery Department, Faculty of Medicine Menoufia University, Menoufia, Egypt

Email

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City

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Orcid

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First Name

Haytham Shaker Ahmed

Last Name

Rezq

MiddleName

-

Affiliation

Plastic Surgery Department, Faculty of Medicine Menoufia University, Menoufia, Egypt

Email

drhaythamshaker@yahoo.com

City

-

Orcid

-

Volume

84

Article Issue

1

Related Issue

25405

Issue Date

2021-07-01

Receive Date

2021-06-19

Publish Date

2021-07-01

Page Start

1,832

Page End

1,838

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_178612.html

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https://ejhm.journals.ekb.eg/service?article_code=178612

Order

47

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

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

Details

Type

Article

Created At

22 Jan 2023