{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:49:37Z","timestamp":1765828177544,"version":"3.41.2"},"reference-count":11,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,3,17]],"date-time":"2022-03-17T00:00:00Z","timestamp":1647475200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Proximal hypospadias\u00a0defects represent the most challenging aspect of maintaining blood supply to the flap, which eventually leads to a high rate of complications. We modified a sealed Y\u2010shaped penis foreskin vascular protection technique, which can repair the urethra in a single stage. The inner plate of the foreskin was cut along the coronal sulcus, and both sides of the urethral plate were cut as deep as Buck's fascia. The \"Y\"\u2010shaped foreskin flaps on both sides of the mouth that are continuous with the urethral plate were sutured to form a new urethral skin tube. The urethral skin tube was turned to the ventral side, and the foreskin was reshaped and sutured. A total of 89 children had their urinary catheters removed 4\u00a0weeks after the operation. All children were evaluated at least once a year for 3 consecutive years. There were 11 patients with urine leakage that occurred after the operation. These children, diagnosed with urine leakage, underwent successful repair after the leakage occurred. There were no urethral strictures after the operation. The one\u2010time success rate of this operation was 87.6% (78\/89), and the incidence of urethral fistula was 12.6% (11\/89). The results showed that sealed Y\u2010shaped penis foreskin vascular protection surgery was safer and had a higher operation rate than the traditional\u00a0hypospadias repair technique. Modifying Koyanagi repair by our\u00a0improved\u00a0Koyanagi hypospadias repair is an excellent technique with relatively low complication rates.<\/jats:p>","DOI":"10.1002\/ccr3.5575","type":"journal-article","created":{"date-parts":[[2022,3,17]],"date-time":"2022-03-17T15:15:03Z","timestamp":1647530103000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Neomodified Koyanagi technique for severe hypospadias with one\u2010stage sealed Y\u2010shaped penis foreskin vascular protection surgery"],"prefix":"10.1002","volume":"10","author":[{"given":"Jiancheng","family":"Zu","sequence":"first","affiliation":[{"name":"Hunan Children's Hospital Changsha City China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifu","family":"Chen","sequence":"additional","affiliation":[{"name":"Hunan Children's Hospital Changsha City China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Liu","sequence":"additional","affiliation":[{"name":"Hunan Children's Hospital Changsha City China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianqu","family":"He","sequence":"additional","affiliation":[{"name":"Hunan Children's Hospital Changsha City China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4794-3623","authenticated-orcid":false,"given":"Yanling","family":"Wang","sequence":"additional","affiliation":[{"name":"Changsha Hospital for Maternal and Child Health Care of Hunan Normal University Changsha City China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuee","family":"Zu","sequence":"additional","affiliation":[{"name":"Changsha Hospital for Maternal and Child Health Care of Hunan Normal University Changsha City China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9110-5163","authenticated-orcid":false,"given":"Xiangwen","family":"Peng","sequence":"additional","affiliation":[{"name":"Changsha Hospital for Maternal and Child Health Care of Hunan Normal University Changsha City China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,17]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"68","article-title":"Surgical repair of anterior hypospadias with fish\u2010mouth meatus and intact prepuce based on anatomical characteristics","volume":"4","author":"Nonomura K","year":"1998","journal-title":"Eur Urol"},{"key":"e_1_2_11_3_1","first-page":"06","article-title":"Experience with one\u2010stage repair of severe proximal hypospadias: operative technique and results","volume":"4","author":"Koyanagi T","year":"1993","journal-title":"Eur Urol"},{"key":"e_1_2_11_4_1","first-page":"51","article-title":"Current concepts in hypospadias surgery","volume":"5","author":"Hayashi Y","year":"2008","journal-title":"Int J Urol"},{"issue":"2","key":"e_1_2_11_5_1","first-page":"73","article-title":"Modification of the Koyanagi technique for the single stage repair of proximal hypospadias","volume":"64","author":"Emir H","year":"2016","journal-title":"J Urol"},{"key":"e_1_2_11_6_1","first-page":"75","article-title":"New modification of the Koyanagi technique for the one\u2010stage repair of severe hypospadias","volume":"3","author":"Kang L","year":"2016","journal-title":"Urology"},{"key":"e_1_2_11_7_1","first-page":"051","article-title":"Severe hypospadias repair with meatal based paracoronal skin flap: the modified Koyanagi repair","volume":"66","author":"Sugita Y","year":"2001","journal-title":"J Urol"},{"key":"e_1_2_11_8_1","first-page":"354","article-title":"A multicenter evaluation of technical preferences for primary hypospadias repair","volume":"74","author":"Cook A","year":"2006","journal-title":"J Urol"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000143880.13698.ca"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.05.170"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-4295(75)90070-9"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2006.09.104"}],"container-title":["Clinical Case 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