Comparison between dorsal onlay and one‐sided dorsolateral onlay buccal mucosal graft urethroplasty in long anterior urethral strictures

• Published in: International journal of urology Vol. 27; no. 9; pp. 719 - 724
• Main Authors: Kartal, Ibrahim, Çimen, Sertaç, Kokurcan, Alihan, Akay, Emin Ozan, Yiğitbaşı, Orhan, Yalçınkaya, Fatih
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01-09-2020
• Subjects: Buccal mucosa; Humans; Male; Mouth Mucosa; onlay; Patients; Retrospective Studies; Stricture; Success; Treatment Outcome; Urethra - surgery; urethral stricture; Urethral Stricture - surgery; urethroplasty; Urologic Surgical Procedures, Male - adverse effects; urethral stricture; urethroplasty; buccal mucosa; onlay; treatment outcome
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/iju.14286

Objective
To compare dorsal onlay (conventional Barbagli) and one‐sided dorsolateral onlay (Kulkarni technique) buccal mucosa substitution urethroplasty techniques for the treatment of long anterior urethral strictures.
Methods
Demographic data, treatment outcomes and success rates of patients who underwent either conventional Barbagli or Kulkarni urethroplasty for the treatment of an anterior urethral stricture longer than 8 cm between January 2010 and March 2019 in our center were retrospectively reviewed.
Results
Demographic parameters of patients who underwent the conventional Barbagli (n = 37) or Kulkarni procedure (n = 31) did not differ. The mean surgical duration and hospital stay were shorter for patients treated with the Kulkarni technique (179.5 ± 30.0 and 3.5 ± 1.2 vs 195.5 ± 28.9 min and 4.4 ± 1.8 days; P = 0.037, P = 0.002). Mean intraoperative blood loss and perioperative complication rates were signficantly lower in patients who underwent the Kulkarni technique than those who underwent the conventional Barbagli technique (164.3 ± 62.9 vs 202.4 ± 78.1 mL; P = 0.033 and 16.1% vs 37.8%; P = 0.046). The mean follow‐up time period was 59.8 ± 24.7 and 63.5 ± 26.8 months for Kulkarni and conventional Barbagli techniques, respectively. Success rates based these follow‐up time periods were 27 (87.1%) and 26 (70.3%) for the Kulkarni and conventional Barbagli techniques, respectively.
Conclusion
The Kulkarni technique should be more preferred for the treatment of long anterior urethral strictures over the conventional Barbagli technique based on surgical outcomes and success rates.