In this study, we aimed to present the results of our double buccal mucosal urethroplasty series for panurethral strictures.

We included the first 20 patients who were operated between January 2015 and June 2017 and had at least 6 months follow-up. From the first case, all data were recorded prospectively and we collected patient age, etiology of the stricture, comorbidities, previous treatments, concomitant meatal stenosis, postoperative maximal flow rate (Q max), pre and post-operative International Index of Erectile Function (IIEF-5) scores, perioperative and postoperative complications and QOL questionnaire for this study. All of the patients were performed one stage double buccal mucosal graft urethroplasty with one side dissection of the urethra which was described by Kulkarni.

The preoperative data, patient's characteristics and the postoperative results of the patients has shown at the table.

The mean patient age was 54.7 and mean stricture length was 13.6 (between 10 and 16) centimeters. Patients had previously 1 to 17 (median 3) procedures. Patients had a mean peak flow rate (Qmax) of 25.7 ml/sec (between 12.1 and 38.7 ml/sec) at the first postoperative visit.
During the follow-up period, 4 patients had recurrence and managed with direct vision internal urethrotomy, re-urethroplasty with buccal graft and urethral dilatation and meatoplasty.
The responses to the questions about satisfaction from the surgery showed that 18 (90%) patients were satisfied with the surgery, 17 (85%) would prefer this procedure again, if needed, and 17 (85%) patients recommended this procedure to others. Regarding buccal mucosa harvesting, 15 (75%) patients were contented about buccal mucosa harvesting, 13 (65%) were positive about consenting again for buccal mucosa harvesting, and 11 (55%) accepted urethroplasty with buccal mucosa again although they had been offered another alternative.

In this study, we demonstrated that Kulkarni’s one-stage double buccal mucosa urethroplasty technique has a high success rate in patients with panurethral strictures. The patient satisfaction is high because of the good functional outcomes and low complication rate. Our study showed that, after a proper training this technique can be transferred to any center and easily applicable. Although the success rate is high, there is a lack of information in the literature about the factors affecting recurrences. Further studies with higher number of patients are needed to clarify this issue.