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The following is a summary of “One-Sided Dorsal Onlay Urethroplasty With Penile Invagination (Kulkarni Urethroplasty) for Complex Anterior Urethral Strictures: A Single-Center Experience,” published in the March 2025 issue of International Journal of Urology by Takekawa et al. 

Researchers conducted a retrospective study to evaluate surgical and patient-reported outcomes of one-sided dorsal onlay urethroplasty with penile invagination in males with complex anterior urethral strictures.  

They reviewed 39 male patients who underwent Kulkarni urethroplasty from 2016 to 2024. One-sided urethral mobilization with penile invagination was performed through a perineal approach, using oral mucosa graft (OMG) or penile skin graft (PSG) as the urethral substitute. Success was defined as passing flexible cystoscopy without resistance and voiding without additional interventions. Patient-reported outcomes were assessed using urethral stricture surgery patient-reported outcome measure (USS-PROM), sexual health inventory for men (SHIM), and EuroQol-5 dimensions (EQ-5D), with follow-ups at 3, 6, and 12 months postoperatively and then annually. 

The results showed a median stricture length of 44 mm (IQR 27–84) and a median follow-up of 12 months (IQR 6–34). The overall success rate was 89.7% (80.0% for OMG, 95.8% for PSG). Maximum flow rate, post-void residual volume, lower urinary tract symptoms (LUTS) score, LUTS-related quality of life, EQ-5D score, and EQ-visual analog scale improved significantly (all P < 0.001). SHIM scores remained unchanged, indicating preserved erectile function and 2 (5.2%) had grade 2 donor-site complications. 

Investigators demonstrated excellent surgical outcomes and significant improvements in patient-reported outcomes while preserving erectile function. Both OMG and PSG were viable options for this procedure. 

Source: onlinelibrary.wiley.com/doi/abs/10.1111/iju.70048