Koyanagi手术及其改良术式治疗重型尿道下裂

目的 探讨Koyanagi手术及其改良手术治疗重型尿道下裂的效果。方法 回顾性总结采用Koyanagi手术和改良手术治疗的34例阴囊型、会阴型尿道下裂的临床资料，分析近年来该手术的进展，探讨该手术的要点及优缺点。结果 本组34例中尿瘘4例（11．8％），无尿道和尿道口狭窄发生，3例阴茎头裂开尿道口退缩至冠状沟平面，改良手术组7例发生阴茎部分旋转，其余阴茎外观及尿道功能良好，全部病例均获得了3个月以上的随访。结论 大多数重型尿道下裂可采用Ⅰ期手术方法修复，并且效果满意，Koyanagi手术及其改良手术尤其适用于伴有部分阴茎阴囊转位、包皮组织较少的重型尿道下裂的Ⅰ期修复。

Koyanagi repair for severe proximal hypospadias

Objective To review our experience in the treating severe proximal hypospadias by the Koyanagi operation.Methods The medical records of 36 consecutive patients with severe proximal hypospadias were retrospectively analyzed.Twelves patients were treated by the Koyanagi procedure,and other 24 cases by the modified Koyanagi procedure.Results All the patients were followed-up for more than 3 months.The urethrocutaneous fistula developed in 4 patients((11.1%)).Meatal retraction was found in 3 cases.No patient developed urethral and meatal stenosis.Good cosmetic and urethral functional results were achieved in the remaining patients.Conclusions We believe that the single stage repair can be safely and effectively performed and satisfactory result can be achieved in the most patients with the severe proximal hypospadias.The Koyanagi and the modified Koyanagi procedures can be the treatment of choice for the severe hypospadias associated penoscrotal transposithion with insufficient prepretial tissue.