Urology – Original Paper

International Urology and Nephrology

, Volume 44, Issue 5, pp 1311-1318

Kutlay technique for hypospadias repair

  • Ilhan GecitAffiliated withDepartment of Urology, School of Medicine, Yuzuncu Yil University
  • , Daghan IsikAffiliated withDepartment of Plastic and Reconstructive Surgery, School of Medicine, Yuzuncu Yil University Email author 
  • , Necip PirincciAffiliated withDepartment of Urology, School of Medicine, Yuzuncu Yil University
  • , Salim BiliciAffiliated withDepartment of Pediatric Surgery, School of Medicine, Yuzuncu Yil University
  • , Mustafa GunesAffiliated withDepartment of Urology, School of Medicine, Yuzuncu Yil University
  • , Yasin CanbazAffiliated withDepartment of Plastic and Reconstructive Surgery, School of Medicine, Yuzuncu Yil University
  • , O. Faruk KocakAffiliated withDepartment of Plastic and Reconstructive Surgery, School of Medicine, Yuzuncu Yil University

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Abstract

Objective

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.

Patients and methods

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.

Results

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.

Conclusion

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.

Keywords

Hypospadias Kutlay technique Meatal-based flap Chordee