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  6. One-sided Dorsal Onlay Urethroplasty With Penile Invagination (kulkarni Urethroplasty) For Complex Anterior Urethral Strictures: A Single-center Experience

One-Sided Dorsal Onlay Urethroplasty With Penile Invagination (Kulkarni Urethroplasty) for Complex Anterior Urethral Strictures: A Single-Center Experience

Kazuki Takekawa1, Akio Horiguchi1,2, Masayuki Shinchi1

  • 1Department of Urology, National Defense Medical College, Saitama, Japan.

International Journal of Urology : Official Journal of the Japanese Urological Association
|March 20, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Kulkarni urethroplasty shows high success for complex anterior urethral strictures, improving urinary symptoms and quality of life while preserving erectile function. Oral mucosa graft and penile skin graft are effective options.

Area of Science:

  • Urology
  • Reconstructive Surgery

Background:

  • Complex anterior urethral strictures pose significant challenges in male patients.
  • Traditional surgical approaches may have limitations in treating extensive strictures.

Purpose of the Study:

  • To evaluate the surgical and patient-reported outcomes of Kulkarni urethroplasty for complex anterior urethral strictures.
  • To assess the efficacy of oral mucosa graft (OMG) and penile skin graft (PSG) in this procedure.

Main Methods:

  • Retrospective review of 39 male patients undergoing Kulkarni urethroplasty (2016-2024).
  • Perineal approach with penile invagination for anterior urethral access.
  • Use of OMG or PSG as urethral substitutes.
  • Assessment of outcomes via cystoscopy, uroflowmetry, post-void residual, and validated questionnaires (USS-PROM, SHIM, EQ-5D).
Keywords:
Kulkarni urethroplastyanterior urethral stricturedorsal onlay urethroplastypatient‐reported outcome

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Main Results:

  • Overall success rate of 89.7% at a median 12-month follow-up.
  • Significant improvements in urinary flow, lower urinary tract symptoms (LUTS), and quality of life (p < 0.001).
  • Preserved erectile function (unchanged SHIM scores) and low donor-site complication rate (5.2%).

Conclusions:

  • Kulkarni urethroplasty is an effective technique for complex anterior urethral strictures, offering high success rates.
  • The procedure significantly enhances patient-reported outcomes and preserves erectile function.
  • Both OMG and PSG are viable graft options for Kulkarni urethroplasty.
quality of life