Difficulty : ⭐️⭐️⭐️
The perineal incision allows the entire urethra to be approached by reversal without having to devascularise the skin sheath.
This reversal technique, also known as the Kulkarni approach, makes it possible to perform a GMB enlargement of the entire urethra, from the prostate to the meatus. This is the technique described here: the urethra and spongiosa are separated from the cavernosum by freeing a gutter at the bottom of which the mucosal graft will be fixed. This graft is then sutured to the edges of the medial stenotic urethra.
Depending on the length of the stenosis, the repair can be performed by this single approach from the prostatic apex to the meatus (panurethroplasty according to Kulkarni).
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