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

Abstract

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. 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 8cm between January 2010 and March 2019 in our center were retrospectively reviewed. 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±28.9min and 4.4±1.8days; 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±78.1mL; 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±26.8months 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. 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.