The "Mini-Kulkarni": A Promising New Technique for the Treatment of Strictures of the Fossa Navicularis and Urethral Meatus
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Objective To present the "Mini-Kulkarni" technique, a modification of the established Kulkarni approach for the management of urethral meatus and fossa navicularis strictures, and to demonstrate that glans preservation provides important patient benefits. Methods Six patients with urethral stricture in the urethral meatus and navicular fossa, limited to 5 cm of the distal penile urethra, confirmed by urethrocystography, were treated with the Mini-Kulkarni technique. This approach involves a longitudinal incision in the distal third of the penile shaft over the prepuce while preserving the glans, lateral rotation of the distal urethra, and placement of a jugal mucosa graft. Follow-up included uroflowmetry and patient-reported outcomes. Results All patients demonstrated improved urinary flow post-surgery. The mean maximum flow rate increased from 7.8 ml/s preoperatively to 15.2 ml/s at 6 months follow-up in the patients with available data. Complications included urinary spray in one patient and recurrence of stricture in another, with no cases of fistula formation or glans dehiscence. Conclusion The Mini-Kulkarni technique represents a promising approach for the treatment of navicular fossa and urethral meatus strictures. This technique offers a less invasive alternative compared to conventional approaches, preserving the glans and potentially reducing postoperative complications. Preliminary results indicate patient satisfaction after six months of follow-up. Further studies with longer follow-up periods and more comprehensive evaluation protocols are needed to validate the long-term efficacy and safety of this technique.