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Urethral stricture refers to anterior urethral disease, or a scarring process involving the spongy tissue of the corpus spongiosum. Urethral stricture disease is one of the oldest and most difficult maladies known to urologist. Surgical treatment of urethral stricture disease is a continually evolving process, and currently there is renewed controversy over the best means of reconstructing the urethra. There are a number of factors that influence the outcome of surgery including location of the stricture, stricture length, etiology, previous surgery and selection of procedure. Urethrotomy continues to be the most commonly used technique, but it has high failure rate. Short bulbar strictures are amenable using primary end-to-end anastomosis, with a high success rate. Buccal mucosa has become the most popular substitute material in urethroplasty. Longer strictures are repaired using ventral or dorsal graft urethroplasty, with the same results. Both the patient and the physician must have a good understanding of the goal of treatment before treatment choice is made. To this end, treatment options should be discussed with the patient, with care taken to emphasize the anticipated outcome with regard to cure.
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