Neo-modified Koyanagi technique for the single-stage repair of proximal hypospadias

PurposeTo retrospectively analyze the results of a modification of the Koyanagi hypospadias repair developed to reduce complications.Materials and methodsTwelve boys underwent a modified Koyanagi repair over the past 3 years. The technique included the preservation of a wide vascular pedicle for each parameatal flap. The distal urethral plate was left intact and attached on each lateral side to the medial side of each distal Koyanagi pedicle flap.ResultsOne boy (8%) developed a urethral fistula. There was no instance of meatal stenosis, sacculation or urethral stricture.ConclusionsModifying the Koyanagi repair by preserving a wide vascular pedicle for the distal skin flaps and utilizing the distal urethral plate as the base for the distal neourethra has lowered the incidence of complications. This technique is a suitable alternative to a two-stage approach for the correction of proximal hypospadias.