• Kulkarni Center for Reconstructive Urology

    Located in Pune, India, Kulkarni Center is an international tertiary referral center for urethral reconstruction. This unique hospital offers comprehensive care for the treatment of urethral strictures including an outpatient clinic, a full range of investigative tools (i.e. uroflowometry,, X-ray studies of the urethra, endoscopy, lab), operating rooms, and comfortable inpatient rooms. Stricture patients can come here without an appointment and get complete diagnosis, treatment, and care of their disease. It is not uncommon for a patient to travel from other countries to our front door and receive a medical evaluation and urethral reconstructive surgery within a 24 hr period. Since patients often travel from far away places, we never reject treatment. We provide affordable care for those who can afford it, and free care for those who can’t.

Recent Articles

Post Prostatectomy Urethral Strictures/Stenoses are in Predictable Locations

Sanjay B. Kulkarni MS, FRCS, Pankaj M. Joshi DNB Urology, and Mang L. Chen, MD

Radical Prostatectomy Patients with localized prostate cancer and a life expectancy greater than 10 years are generally offered radical prostatectomy (RP) for cure. Removing the prostate requires that the bladder neck be anastomosed to the membranous urethra. As with all anastomoses, the bladder neck/membranous urethra anastomosis is at risk (though low) for narrowing. This is […]

Innovations by Dr. Sanjay Kulkarni

Sanjay B. Kulkarni MS, FRCS, Pankaj Joshi MS, DNB, Krishnan Venkatesan, MD, and Mang L. Chen, MD

New Operations Invented and Presented by Dr. Sanjay Kulkarni Contralateral Ureterolithotomy: Video presentation at American Urology Association, Annual Meeting, Atlanta, 2000 A new technique of Urethroplasty for BXO: Video presentation at American Urology Association, Annual Meeting, Atlanta, 2000(New penile invagination technique) A new technique of Urethroplasty for Watering Can Perineum: Video presentation atAmerican Urology Association, […]

Complex Strictures

Sanjay B. Kulkarni MS, FRCS and Mang L. Chen, MD

Redo Urethroplasty: Failed anastomotic urethroplasty for posterior urethral injuries. The most common cause for failure is inadequate excision of the scar at the apex of the posterior urethra. Unless, I see soft-to-touch, pink and mobile urethra with no white firm scar around the urethra, I do not perform the anastomosis. Hematoma and ischemia of the […]

Types of Urethroplasty

Sanjay B. Kulkarni MS, FRCS and Mang L. Chen, MD

Bulbar Anastomotic Urethroplasty Anastomatic urethroplasty is a treatment of choice for bulbar urethral trauma at some centers. It is generally performed for short bulbar strictures of non traumatic origin. In my practice, I follow the rule of transecting the bulbar urethra only when it is already transected by trauma. Under spinal anesthesia the patient is […]

Management of Urethral Strictures

Sanjay B. Kulkarni MS, FRCS

Dilation Dilation was known to ancient civilizations. It was considered the standard treatment for managing strictures of the urethra over centuries. The aim dilation is to stretch the scar without bleeding so the narrow urethral lumen is stretched temporarily and the patient can void well. Dilation needs to be repeated either daily or on alternate […]

Diagnosis of Strictures

Sanjay B. Kulkarni MS, FRCS

Uroflowmetry Any patient who presents with poor flow needs uroflowmetry. Hesitancy and poor flow, less than 10ml/sec with a flat box type of curve suggests a stricture in the urethra. Urethroscopy and Cystoscopy Many times a stricture is diagnosed when a panendoscopy is performed for other problem such as TURP or Bladder stone. USG abdominal […]

Symptoms of Urethral Strictures

Sanjay B. Kulkarni MS, FRCS

Clinical Presentation Any patient who presents with poor flow may have a stricture. Other symptoms are:hesitancy,poor flow,feeling of incomplete bladder emptying,dysuria,urinary tract infection. Many patients know they have a stricture and are under treatment. After dilatation the patient may get pain, fever, bleeding per urethra. I have seen patient presenting with chronic renal failure due […]

History of Urethroplasty

Timeline by Sanjay B Kulkarni MS, FRCS and Mang L Chen, MD

History of Urethral Stricture Management 1 Ancient India Susruta:urethral dilation with reed catheter lubricated with ghee. Greece, Socrates: record of his joking about patients weak flow Greece, Epicurus: committed suicide when he could no longer dilate his stricture. Rome in the first century, Celsus: described external urethrotomy for treatment of a stone impacted behind a […]

Etiology of Strictures

Sanjay B. Kulkarni MS, FRCS

Etiology of strictures Congenital: rare I have seen “Cobb’s collar” white ring (narrowing but not tight) in the proximal bulbar urethra occasionally in adults with no positive history related to the etiology of the stricture. Trauma Penile -direct penetrating injury or gunshot wound Bulbar- Falling astride or a perineal kick Membranous- Pelvic fracture urethral distraction […]

Anatomy and Pathophysiology of Urethral Strictures

Sanjay B. Kulkarni MS, FRCS

The male urethra is divided in to anterior part of meatus, penile and bulbar portions and posterior part of membranous and prostatic urethra. The anterior urethra is surrounded by corpora spongiosa and the narrowing of the urethral lumen due to spongiofibrosis is called a stricture. The posterior urethra is devoid of corpora spongiosa and the […]