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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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 ORIGINAL ARTICLE
Year : 2013  |  Volume : 18  |  Issue : 3  |  Page : 96-99

Modified koyanagi repair for severe hypospadias


1 Department of Paediatric Surgery; Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
2 Bangalore Medical College and Research Institute, Bangalore, Karnataka, India

Correspondence Address:
Anand Alladi
7, Gupta Layout, Southend Road, Basavanagudi, Bangalore - 560 004, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9261.116041

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Aim: To report the results of an early series of patients who underwent modified Koyanagi repair for severe hypospadias. Materials and Methods: A total of 24 boys (age: 9 months to 11 years) with proximal hypospadias, chordee, and poor urethral plate underwent modified Koyanagi repair between September 2008 and January 2012. Nine boys had associated penoscrotal transposition that was corrected simultaneously. Vascularized parameatal based foreskin flap was used to correct the hypospadias in a single stage. The follow-up ranged from 6 months to 3.5 years. Results: A total of 13 of the 24 children had a good outcome and were voiding normally, while 11 boys developed complications, 3 of which were major and 8 minor. The major complications were complete breakdown (n = 1), meatal and distal neourethral stenosis requiring laying open of distal urethra (n = 1), and glans breakdown (n = 1). The minor complications included fistulae (n = 5), meatal stenosis amenable to dilatation (n = 1), and lateral chordee (n = 1). Majority of the complications were in the initial patients, with successful outcomes in the last 1 year. Most of these complications were successfully managed by minor second procedures. Conclusion: Modified Koyanagi repair not only corrects severe hypospadias with chordee but also corrects the associated penoscrotal transposition in a single stage. The results are good once the learning curve is crossed.






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