Efficacy of urethroplasty with the Kulkarni technique in urethral panstenosis: experience of the Hospital Central Militar (2020–2024)
DOI:
https://doi.org/10.48193/wh1at845Keywords:
Urethral stricture, urethroplasty, buccal mucosa, surgical procedures operative, quality of lifeAbstract
Objective: to evaluate the clinical and functional outcomes of single-stage urethroplasty using the Kulkarni technique in patients with panurethral stricture disease treated at a national military referral center between 2020 and 2024.
Methods: an observational retrospective study was conducted including male patients with panurethral strictures measuring ≥8 cm who underwent urethroplasty with the Kulkarni technique. Demographic data, comorbidities, etiology, uroflowmetry parameters, quality-of-life scores (EQ-VAS, EQ-5D-3L, IIEF-5, MSHQ-EjD, ICIQ-MLUTS, ICIQ-UI SF), and postoperative complications were analyzed. Continuous variables were summarized using medians and interquartile ranges. Paired differences in quality-of-life scores were assessed using the Wilcoxon test. Recurrence-free survival was evaluated with Kaplan–Meier analysis.
Results: eighteen patients were included (median age 62 years). The most frequent etiology was iatrogenic injury (61.1 %), followed by lichen sclerosus and trauma (16.7 % each). The preoperative Qmax was 8 mL/s, increasing to 14.4 mL/s at three months and remaining stable at 12 and 24 months. EQ-VAS scores improved from 70 to 95 points at follow-up (p < 0.001). Sexual-function and urinary-symptom scores demonstrated significant improvement across all instruments. Postoperative complications were infrequent and mild, with no reoperations or infections recorded. Median follow-up was 27 months, and no recurrences were identified, yielding a recurrence-free survival of 100 %.
Conclusions: single-stage urethroplasty using the Kulkarni technique demonstrated favorable clinical and functional outcomes in patients with panurethral strictures, with sustained symptom improvement, low complication rates, and no recurrences during follow-up. These findings support its use as an effective and safe reconstructive option for extensive anterior urethral disease.
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