Multi-Institutional Outcomes of a One-Sided Dorsal Onlay Buccal Mucosal Urethroplasty for Penile Urethral Strictures Accessed Via a Penoscrotal Incision
Introduction: Optimal surgical management of penile urethral strictures remains unclear. Herein, we report our multi-institutional series of patients undergoing a one-sided dorsal onlay buccal mucosal urethropalsty for penile urethral strictures accessed via a penoscrotal invagination technique. Methods: We retrospectively reviewed consecutively treated penile urethral stricture patients who underwent a one-sided dorsal onlay buccal mucosal urethroplasty accessed via a penoscrotal incision and penile invagination across 7 institutions. This technique is a modification of the Kulkarni invagination technique to include penoscrotal rather than perineal incision for penile strictures. Thus, allowing for supine positioning, and less dissection to reach the stricture location. Minimum 4 months follow up was required for inclusion. Primary outcomes were stricture recurrence and complications. Results: We identified 23 patients. Median age was 60 (20-74). Stricture etiology included trauma (1), lichen sclerosis (2), instrumentation (14), and 6 were idiopathic. Median stricture length was 5cm (1.5-10cm). Only 30% (7/23) patients had not previously received stricture treatment. Using the LSE nomogram, 15 were classified as 2b strictures and 9 as 2c. Post-operative complications occurred in 5 patients and included leaks (2), cellulits (1), penile edema (1), and sepsis (1). With median follow-up of 7 months, long-term (>30 day) complications included 1 fistula, 1 Peyronie’s, and 3 (13%) stricture recurrences. Conclusion: This modified Kulkarni technique for management of penile strictures is safe, feasible, and reproducible across multiple different institutions. This confers decreased incision-related morbidity with stricture outcomes comparable to more traditional techniques
Abramowitz D, Balzano F, Simhan J, Burks F, Nikolavsky D, Blakely S, et al. Multi-institutional outcomes of a one-sided dorsal onlay buccal mucosal urethroplasty for penile urethral strictures accessed via a penoscrotal incision. Paper presented at: The 95th Annual Meeting of the North Central Section of the AUA; 2021 Oct 6-9; Chicago, IL. Available at: https://ncsaua.org/docs/meetings/ncs2110/ncs-2021-program-book.aspx
The 95th Annual Meeting of the North Central Section of the AUA, Chicago, IL, October 6-9, 2021.