Twenty-five Years of Panurethral Stricture Repair Using the Kulkarni Technique

Panurethral stricture disease represents one of the most challenging conditions in reconstructive urology. Over the past 25 yr, surgical management has evolved from staged skin substitution to single-stage panurethroplasty. The introduction of dorsal buccal mucosal graft urethroplasty and its refinement into the one-sided dissection technique established a reproducible strategy with durable long-term success rates of 80-85% in large series. Limitations of oral graft length and donor-site morbidity have led to further innovation, including the spiral preputial graft, which enables continuous long-segment reconstruction in selected patients. Contemporary multicenter data support acceptable intermediate-term outcomes, although careful patient selection remains essential. PATIENT SUMMARY: Long urethral strictures can now often be repaired in one operation using tissue grafts. These modern techniques provide good long-term results when performed in specialized centers.