KẾT QUẢ ĐIỀU TRỊ MIỆNG NIỆU ĐẠO ĐÓNG THẤP THỂ SAU BẰNG KỸ THUẬT KOYANAGI CẢI TIẾN CÓ KẾT HỢP VẬT LIỆU CHE PHỦ BẰNG MẢNH BAO TINH MẠC

Abstract

Objective: To evaluate the outcomes and complications of one-stage repair using the modified Koyanagi–Hayashi technique with tunica vaginalis flap coverage in the treatment of proximal hypospadias at Children’s Hospital 2. Methods: A descriptive case series was conducted on pediatric patients with proximal hypospadias who underwent single-stage repair using the Hayashi-modified Koyanagi technique combined with neourethral coverage using a tunica vaginalis flap. Patients were followed for a minimum of 6 months postoperatively. Primary variables included clinical and operative characteristics, early and late complications, and overall success rate. Results: A total of 31 patients were included. Early complications included surgical site infection and scrotal hematoma. The most common late complication was meatal dehiscence, occurring in 12 patients (38.7%), of whom 5 required reoperation. Other late complications included urethrocutaneous fistula in 2 patients (6.5%) and recurrent penile curvature in 4 patients (12.9%). No severe complications such as urethral stricture or severe recurrent chordee requiring redo urethral plate transection were observed. The overall success rate was 77.5%. Conclusion: The Koyanagi–Hayashi single-stage repair is a feasible and safe option for proximal hypospadias. The use of a balloon urethral catheter combined with tunica vaginalis flap coverage of the neourethra resulted in a significantly improved success rate compared with previous studies conducted on the same patient population at Children’s Hospital 2.