A simplified and unified approach to anterior urethroplasty

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Abstract
Management of urethral strictures can be challenging, given the heterogeneity of the disease and the myriad surgical techniques from which to choose. In this Review, Drs. Zimmerman and Santucci describe three urethroplasty procedures—anastomotic, buccal mucosal graft-onlay and the two-staged Johanson urethroplasty—that can accommodate the majority of patients and give good long-term results. The management of patients with urethral stricture can be a complex process. However, with the appropriate tools, the urologist experienced in urethral surgery can manage most cases without too much difficulty. Here, we describe three surgical techniques—anastomotic urethroplasty, buccal mucosal graft-onlay urethroplasty and the two-staged Johanson urethroplasty—that, in our experience, can accommodate the majority of patients with urethral stricture and provide excellent long-term results. Diagnosis and evaluation of candidacy for each of the surgical techniques are important aspects of treatment planning, and are also described. The aim of the article is to increase the awareness of the technique and application of these three urethroplasty procedures, which can be implemented by all urologists who actively care for and surgically treat patients with urethral stricture disease.

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