The effectiveness of Barbagli technique compared to Kulkarni technique for urethral strictures: a systematic review and meta-analysis

Abstract

Introduction: Urethroplasty is one of the management of urethral stricture. Various studies reported that urethroplasty procedures have a higher long-term success rate than urethrotomy for treating urethral stricture. We aim to compare the efficacy and safety of urethroplasty using the Barbagli and Kulkarni approaches. Materials and Methods: This systematic review and meta-analysis were performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We systematically searched for relevant articles through several databases. The outcomes evaluated in this study were success rate, mean operative time, and complication rate. Outcomes with dichotomous data were analyzed using odds ratio (OR). Continuous data will be analyzed using mean difference (MD) and standard deviation (SD). Statistical analysis using RevMan 5.4 for Windows. Results: Three studies were evaluated involving 272 urethral stricture patients. Urethroplasty procedure using the Barbagli technique had a success rate that was not significantly different from that of the Kulkarni technique (OR 0.55, 95% CI 0.28-1.08, p = 0.08). The Barbagli technique had a significantly longer duration of operation (MD 10.34, 95% CI 3.83-16.85, p = 0.002). The incidence of surgical wound infection was not significantly different in both groups (OR 2.13, 95% CI 0.46-9.83, p = 0.33). There was no significant difference in overall complication rates between patients undergoing urethroplasty using the Barbagli and Kulkarni technique (OR 1.52, 95% CI 0.42-5.55, p = 0.52). Conclusion: This SRMA found that the success rate in the Barbagli technique urethroplasty procedure was not significantly different from the Kulkarni technique. However, the operation duration was significantly longer in the Barbagli technique. Complication rates were minimal in both groups.