Innovative Approaches for Complex Penile Urethral Strictures

Jordan Siegel; Timothy J. Tausch; Jay Simhan; Allen F. Morey


Transl Androl Urol. 2014;3(2):179-185. 

In This Article


Complex anterior urethra strictures with obliterative segments continue to be a challenging clinical scenario for reconstructive urologists. Past approaches such as tubularized flaps and grafts had an unacceptably high failure rate. Two-stage approaches, while a reasonable option, are not uniformly acceptable to many patients due to the interval between the initial and definitive procedures and treatment fatigue caused by multiple operations. Combined dorsal and ventral buccal grafting or ventral penile flaps have proven successful in these difficult cases and represent viable one-stage options. Further long-term follow up and comparative trials are necessary to fully evaluate these promising techniques. Finally, in the future, the reconstructive urologist is likely to employ more engineered graft material, tailored to each individual patient. Investigation is pending in these innovative materials; however, they do offer the potential of freeing the surgeon from the limitations of current graft options, providing an abundant, non-harvested supply for long, complex repairs.