{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:03:43Z","timestamp":1787169823655,"version":"build-2736575974"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>\n                    Long-segment lichen sclerosus (LS) urethral stricture is a challenge for urologists. Limited data are available for surgeons to make a surgical decision between Kulkarni and Asopa urethroplasty. In this retrospective study, we investigated the outcomes of these two procedures in patients with LS urethral stricture. Between January 2015 and December 2020, 77 patients with LS urethral stricture underwent Kulkarni and Asopa procedures for urethroplasty in the Department of Urology, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine (Shanghai, China). Of the 77 patients, 42 (54.5%) underwent the Asopa procedure and 35 (45.5%) underwent the Kulkarni procedure. The overall complication rate was 34.2% in the Kulkarni group and 19.0% in the Asopa group, and no difference was observed (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.105). Among the complications, no statistical difference was observed in the incidence of urethral stricture recurrence (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.724) or glans dehiscence (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.246) except for postoperative meatus stenosis (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.020). However, the recurrence-free survival rate between the two procedures was significantly different (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.016). Cox survival analysis showed that antiplatelet\/anticoagulant therapy use (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.020), diabetes (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.003), current\/former smoking (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.019), coronary heart disease (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001), and stricture length (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.028) may lead to a higher hazard ratio of complications. Even so, these two techniques can still provide acceptable results with their own advantages in the surgical treatment of LS urethral strictures. The surgical alternative should be considered comprehensively according to the patient characteristics and surgeon preferences. Moreover, our results showed that antiplatelet\/anticoagulant therapy use, diabetes, coronary heart disease, current\/former smoking, and stricture length may be contributing factors of complications. Therefore, patients with LS are advised to undergo early interventions for better therapeutic effects.\n                  <\/jats:p>","DOI":"10.4103\/aja20236","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T07:10:22Z","timestamp":1680851422000},"page":"719-724","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["A comparative study of two single-stage oral mucosal substitution urethroplasty (Kulkarni and Asopa) in the surgical treatments of lichen sclerosus urethral strictures"],"prefix":"10.4103","volume":"25","author":[{"given":"Xiang","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Urology, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai-Jun","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Urology, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Kai","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Urology, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Shu","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Urology, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da-Jun","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Urology, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Urology, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da-Chao","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Urology, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,4,7]]},"reference":[{"key":"R1-20240829","doi-asserted-by":"crossref","first-page":"2268","DOI":"10.1016\/j.juro.2007.08.024","article-title":"Lichen sclerosus:review of the literature and current recommendations for management","volume":"178","author":"Pugliese","year":"2007","journal-title":"J Urol"},{"key":"R2-20240829","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.juro.2009.04.012","article-title":"Clinical outcome and quality of life assessment in patients treated with perineal urethrostomy for anterior urethral stricture disease","volume":"182","author":"Barbagli","year":"2009","journal-title":"J Urol"},{"key":"R3-20240829","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/00005392-200101000-00062","article-title":"The response of balanitis xerotica obliterans to local steroid application compared with placebo in children","volume":"165","author":"Kiss","year":"2001","journal-title":"J Urol"},{"key":"R4-20240829","first-page":"37","article-title":"Clinical and histologic effects of topical treatments of vulval lichen sclerosus. 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