Department of Urology, School of Medicine, Yuzuncu Yil University, Van, Turkey.
Int Urol Nephrol. 2012 Oct;44(5):1311-8. doi: 10.1007/s11255-012-0184-2. Epub 2012 May 3.
Although many techniques have been described, new techniques with a wide range of therapeutic options are needed. The Kutlay technique is a novel technique that is based on the reconstruction of the neourethra with two horizontal meatal-based skin flaps. In the present study, the data of 31 patients who underwent surgery with the Kutlay technique are presented.
Thirty-one patients with hypospadias with an average age of 5.6 years who did not have previous hypospadias repair were operated on with the Kutlay technique. Ten patients had chordee. Among those patients, three patients were circumcised.
The patients were followed up for 4-13 months (average, 9.3 months). During the follow-up period, a fistula was observed in only one patient. None of the patients developed neourethral dehiscence, meatal stenosis, urethral stricture, wound infection, penile torsion, hematoma, or persistent or recurrent chordee. On uroflowmetry studies, the maximum flow rate of the patients was approximately 10.5 ml/s (range, 6-17 ml/s). The patients were observed to void with a single straight urinary stream in a forward direction.
The Kutlay technique is a technique that is easily applied in patients with chordee and that provides a low risk of fistulas and acceptable functional and esthetic results. The factors that reduce the risk of fistula are the lack of the superposition of the suture lines of the skin and the urethra, the reconstruction of the urethra with well-vascularized flaps, and the replacement of the neourethra in its appropriate location through the tunnel created in the glans.
尽管已经描述了许多技术，但仍需要具有广泛治疗选择的新技术。 Kutlay 技术是一种新颖的技术，它基于用两个基于水平尿道口的皮瓣重建新尿道。在本研究中，介绍了采用 Kutlay 技术进行手术的 31 例患者的数据。
31 例伴有平均年龄为 5.6 岁的尿道下裂且未进行过尿道下裂修复的患者接受了 Kutlay 技术手术。10 例患者存在阴茎下弯。其中 3 例患者行包皮环切术。
患者平均随访 4-13 个月（9.3 个月）。在随访期间，仅 1 例患者出现瘘管。没有患者发生新尿道裂开、尿道口狭窄、尿道狭窄、伤口感染、阴茎扭转、血肿或持续性或复发性阴茎下弯。在尿流动力学研究中，患者的最大尿流率约为 10.5ml/s（范围 6-17ml/s）。患者观察到排尿时呈单一直线向前尿流。
Kutlay 技术是一种易于应用于伴有阴茎下弯的患者的技术，其瘘管风险低，且能获得可接受的功能和美学效果。降低瘘管风险的因素包括：皮肤和尿道的缝线无重叠、用血供良好的皮瓣重建尿道，以及通过在龟头创建的隧道将新尿道置于适当位置。
