The Outcomes of Kulkarni’s Dorsal Onlay Buccal Mucosal Graft Urethroplasty in Patients with Anterior Urethral Stricture: A Single Center Experience

Abstract

Objective: To assess the success & the complications of Kulkarni’s dorsal onlay buccal mucosal graft urethroplasty in patients with anterior urethral stricture.

Study Design: Prospective trial study
Place and Duration of Study: This study was conducted at the Basra Urology Center, Iraq between April 2022 and September 2024.

Methods: 20 patients with anterior urethral stricture received Kulkarni's dorsal onlay buccal mucosal graft urethroplasty. Retrograde urethrogram was done one week after removing the Foley’s catheter, and urine flowmetry is usually done 3 & 6 months following the urethroplasty. Patients were kept on follow-up every 3 & 6 months.

Results: The averages of age was 40.65 years, urethral stricture length was 4.25 cm, operative time was (175±7.78 minutes, hospitalization period was 2.35±0.81 days, American Urological Association Symptom Score was
(22.1±3.22) and Q max was 5.47±0.69 ml/s. Successful urethroplasty was achieved in 17 (85%) patients, while 3 patients (15%) had recurrent stricture. There was an improvement in the average maximal urine flow rate to 16.87±0.87 ml/s and 16.42±0.67 ml/s postoperatively at 3 and 6 months respectively. The improvement in the Q max was neither correlated with patients’ age nor with the stricture length. The American Urological Association Symptom Score was improved to 5.15±1.26 and 6.20±1.00 postoperatively at threeand six months.

Conclusion: The dorsal onlay buccal mucosal graft urethroplasty procedure, developed by Kulkarni, shown a low risk of complications and a high success rate.