Abstract
We describe a modification of the Koyanagi technique for hypospadias. Use of opposing parameatal-based skin flaps that extend distally to incorporate the inner layer of the prepuce was modified to preserve blood supply to the flaps in an attempt to reduce complications and improve results. During the last 7 years 20 boys underwent treatment of proximal hypospadias using the modified hypospadias repair. Cosmetic and functional, long-term (mean 34 months) results were excellent. Complications consisted of 4 urethrocutaneous fistulas (20%). There were no instances of meatal stenosis, diverticulum or urethral stricture. The modified technique permits 1-stage repair of proximal hypospadias with a low complication rate.
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