[Yoke technique for severe proximal hypospadias].
PROPOSED: Various techniques have so far been reported for the repair of hypospadias, however, a one-stage procedure for the repair of severe proximal hypospadias still remains difficult to perform. We recently have begun to use the Yoke hypospadias repair technique for the treatment of severe proximal hypospadias.


METHODS
As the chief surgeon, I performed a one-stage hypospadias repair on 40 proximal hypospadiac patients with severe fibrous chordee between July 1992 and December 2004. During the early period, eleven patients underwent urethroplasty by the Transverse Preputial Island Flap techinique (TPIF). Next, 10 patients underwent One-stage Urethroplasty with Parameatal Foreskin flap technique (OUPF IV). Finally, the most recent 19 had their hypospadias repaired by the Yoke technique.


RESULTS
With the TPIF technique in the early periods, only 6 out of 11 patients underwent a successful repair (54.5%). With the OUPF IV technique, the success rate was only 60.0% (6 out of 10 cases). In contrast, 17 out of 19 cases treated by the Yoke technique in the most recent period had a successful repair, although proximal urethrocutaneous fistula and urethral stenosis occurred in one patient, respectively. A relatively high success rate was therefore obtained using the Yoke technique for the repair of severe proximal hypospadias.


CONCLUSIONS
The Yoke techniques for the repair of hypospadias is therefore considered to be a safe and effective technique for the repair of proximal hypospadias because of the continuous skin flap of the ventral urethral plate and the prepuce with a blood supply from the circumferential vascular pedicle. We consider this technique to be very useful for the treatment of severe proximal hypospadias.
Yamaguchi
Takanori
T
Department of Urology, Fukuoka City Medical Center for Sick Children and Infectious Diseases, Fukuoka, Japan.
Koikawa
Yasuhiro
Y
Konomoto
Tatsuo
T
Nakamura
Shigeru
S
Kamimura
Toshio
T
Nagano
Masashi
M
Osada
Yukio
Y
Naito
Seiji
S
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*