A child with Severe Hypospadias - Modified Koyanagi urethroplasty

A 1.5 years old boy was referred to us from Goa with severe hypospadias and chordee

The urinary opening was near the end of scrotum. The penis was also significantly bent (chordee). The diagnosis was scrotal hypospadias with chordee. Since our centre specializes in single stage urethroplasty, we decided to do a single stage repair.

As a first step the penis was degloved and the chordee was corrected using 12 O’clock tunica plication. The Koyanagi flaps were raised on either side going on the top of the penis and these were then joined together in the midline and finally tubularised using 6-0 PDS over 8 Fr stent.

 

Second layer coverage was done with Tunica Vaginalis flap and prepuce on top was split in midline and brought ventrally or coverage of skin. The child did very well and required no further surgery.



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