World Changing Scenario of Urethral Stricture Management
Urethral stricture management remains a great challenge in the urological community. History has shown that the first approach to urethral strictures were to do open reconstructive surgery. Gradually the management changed to minimal invasive surgery but then reverted back to open reconstructive surgery with refined technique and an improvement in medical services. During the past 30 years it has been shown that most urethral strictures are curable with open urethral reconstructive surgery. Despite evidence and international guidelines, internal urethrotomy and dilatation is still practiced by the urological community. A better understanding of the optimal place for minimal invasive surgery in urethral stricture disease should be spread among the urological community. The concept that urethral stricture disease treatment should always start at the bottom with dilatation and or internal urethrotomy and work up the ladder to open reconstructive surgery as the last resort has changed. We aim to provide an overview of the contemporary management of urethral stricture disease from a historical perspective. We will discuss the changing patterns in the last three to four decades and provide evidence and international guideline recommendations about the best treatment option for patients with urethral stricture disease.
KeywordsUrethral stricture Urethrotomy Direct visual internal urethrotomy Urethroplasty
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