Current trends in urethral stricture management

Asian Journal of Urology, 2014, 1 (1): 44-51 doi:

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Current trends in urethral stricture management

Christopher J. Hillary, Nadir I. Osman, Christopher R. Chapple

Department of Urology, Royal Hallamshire Hospital, Sheffield, UK

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Abstract The recent International Consultation on Urological Disease (ICUD) panel 2010 confirmed that a urethral stricture is defined as a narrowing of the urethra consequent upon ischaemic spongiofibrosis, as distinct from sphincter stenoses and a urethral disruption injury.Whenever possible, an anastomotic urethroplasty should be performed because of the higher success rate as compared to augmentation urethroplasty.There is some debate currently regarding the critical stricture length at which an anastomotic procedure can be used, but clearly the extent of the spongiofibrosis and individual anatomical factors (the length of the penis and urethra) are important, the limitation for this being extension of dissection beyond the peno-scrotal junction and the subsequent production of chordee.More recently, there has been interest in whether to excise and anastomose or to carry out a stricturotomy and reanastomosis using a Heineke-Miculicz technique.Augmentation urethroplasty has evolved towards the more extensive use of oral mucosa grafts as compared to penile skin flaps, as both flaps and grafts have similar efficacy and certainly the use of either dorsal or ventral positioning seems to provide comparable results.It is important that the reconstructive surgeon is well versed in the full range of available repair techniques, as no single method is suitable for all cases and will enable the management of any unexpected anatomical findings discovered intra-operatively.

Key words： Urethral stricture Stricture Lichen sclerosus Pelvic fracture Urethral injury Bladder outflow obstruction Urethroplasty Buccal mucosa graft

Received: 15 July 2014 Published: 28 October 2014

Corresponding Authors: Christopher R. Chapple E-mail: c.r.chapple@sheffield.ac.uk

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Christopher J. Hillary,Nadir I. Osman,Christopher R. Chapple. Current trends in urethral stricture management[J]. Asian Journal of Urology, 2014, 1(1): 44-51.

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