Management of Urethral Strictures in Men

  • Richard A. SantucciEmail author
  • Mang L. Chen
Part of the Current Clinical Urology book series (CCU)


Urethral strictures in men often cause bothersome obstructive urinary symptoms and occasionally bladder dysfunction and even renal failure. Management of this disease differs depending on the location and length of the stricture, as well as the patient's overall health and goals. Most patients choose definitive reconstructive surgery since this offers the highest success rate compared to other treatments for urethral strictures.


Urethral Stricture Stricture Recurrence Urethral Dilation Hypospadias Repair Urethral Plate 
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  1. 1.
    Santucci RA, Joyce GF, Wise M. Male urethral stricture disease. J Urol. 2007;177:1667–74.PubMedCrossRefGoogle Scholar
  2. 2.
    Jordan GH, Schlossberg SM. Surgery of the penis and urethra. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 9th ed. Philadelphia: Saunders Elsevier; 2007. p. 1054–75.Google Scholar
  3. 3.
    Morey AF, McAninch JW. Sonographic staging of anterior urethral strictures. J Urol. 2000;163:1070–5.PubMedCrossRefGoogle Scholar
  4. 4.
    Zimmerman WB, Santucci RA. A simplified and unified approach to anterior urethroplasty. Nature. 2010;7:386–91.Google Scholar
  5. 5.
    Burks FN, Santucci RA. Complicated urethroplasty: a guide for surgeons. Nature. 2010;7:521–8.Google Scholar
  6. 6.
    Steenkamp JW, Heyns CF, DeKock MLS. Internal urethrotomy versus dilation as treatment for male urethral strictures: a prospective randomized comparison. J Urol. 1997;157:98–101.PubMedCrossRefGoogle Scholar
  7. 7.
    Santucci RA, Eisenberg L. Urethrotomy has a much lower success rate than previously reported. J Urol. 2010;183:1859–62.PubMedCrossRefGoogle Scholar
  8. 8.
    Wright JL, Wessells H, Nathens AB, Hollingworth W. What is the most cost-effective treatment of 1 to 2 cm bulbar urethral strictures: societal approach using decision analysis. Urology. 2006;67:889–93.PubMedCrossRefGoogle Scholar
  9. 9.
    Shah DK, Paul EM, Badlani GH. North American Study Group: 11-year outcome analysis of endourethral prosthesis for the treatment of recurrent bulbar urethral stricture. J Urol. 2003;170:1255–8.PubMedCrossRefGoogle Scholar
  10. 10.
    De Vocht TF, van Venrooij GE, Boon TA. Self-expanding stent insertion for urethral strictures: a 10-year follow-up. BJU Int. 2003;91:627–30.PubMedCrossRefGoogle Scholar
  11. 11.
    Eisenberg ML, Elliott SP, McAninch JW. Preservation of lower urinary tract function in posterior urethral stenosis: selection of appropriate patients for urethral stenosis. J Urol. 2007;178:245–2461.CrossRefGoogle Scholar
  12. 12.
    Coursey JW, Morey AF, McAninch JW. Erectile function after anterior urethroplasty. J Urol. 2001;166:2273–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Barbagli G, Palminteri E, Rizzo M. Dorsal onlay graft urethroplasty using penile skin or buccal mucosa in adult bulbourethral strictures. J Urol. 1998;160:1307–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Elliott SP, Metro MJ, McAninch JW. Long-term follow-up of the ventrally placed buccal mucosa onlay graft in bulbar urethral reconstruction. J Urol. 2003;169:1754–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Iselin CE, Webster GW. Dorsal onlay urethroplasty for urethral stricture repair. World J Urol. 1998;16:181–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Kellner DS, Fracchia JA, Armenakas NA. Ventral onlay buccal mucosal grafts for anterior urethral strictures: long-term follow-up. J Urol. 2004;171:726–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Paoluzzi LJ. Is hypospadias an ‘environmental’ birth defect? Dial Pediatr Urol. 2000;23:2–4.Google Scholar
  18. 18.
    Chrzan R, Dik P, Klijn AJ, de Jong TP. Quality assessment of hypospadias repair with emphasis on techniques used and experience of pediatric urologic surgeons. Urology. 2007;70:148–52.PubMedCrossRefGoogle Scholar
  19. 19.
    Tang SH, Hammer CC, Doumanian L, Santucci RA. Adult urethral stricture disease after childhood hypospadias repair. Adv Urol. 2008;10:1503–15.Google Scholar
  20. 20.
    Barbagli G, De Angelis M, Palminteri E, Lazzeri M. Failed hypospadias repair presenting in adults. Eur Urol. 2006;49:887–94.PubMedCrossRefGoogle Scholar
  21. 21.
    Meeks JJ, Erickson BA, Gonzalez CM. Staged reconstruction of long segment urethral strictures in men with previous hypospadias repair. J Urol. 2009;181:685–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Mangera A, Patterson JM, Chapple CR. A systematic review of graft augmentation urethroplasty techniques for the treatment of anterior urethral strictures. Eur Urol. 2011;59:797–814.PubMedCrossRefGoogle Scholar
  23. 23.
    Palminteri E, Manzoni G, Berdondini E. Combined dorsal plus ventral double buccal mucosa graft in bulbar urethral reconstruction. Eur Urol. 2008;53:81–90.PubMedCrossRefGoogle Scholar
  24. 24.
    Berglund RK, Angermeier KW. Combined buccal mucosa graft and genital skin flap for reconstruction of extensive anterior urethral strictures. Urology. 2006;68:707–10.PubMedCrossRefGoogle Scholar
  25. 25.
    Dalpiaz O, Kerschbaumer A, Pelzer A. Single-stage dorsal inlay split-skin graft for salvage anterior urethral reconstruction. BJU Int. 2008;101:1565–70.PubMedCrossRefGoogle Scholar
  26. 26.
    Mathur RK, Sharma A. Tunica albuginea urethroplasty for panurethral strictures. Urol J. 2010;7:120–4.PubMedGoogle Scholar
  27. 27.
    Xu YM, Qiao Y, Sa YL. Urethral reconstruction using colonic mucosa graft for complex strictures. J Urol. 2009;182:1040–3.PubMedCrossRefGoogle Scholar
  28. 28.
    Burks FN, Santucci RA. Complicated urethroplasty: a guide for surgeons. Nat Rev Urol. 2010;7:521–8.PubMedCrossRefGoogle Scholar
  29. 29.
    Cooperberg MR, McAninch JW, Alsikafi NF. Posterior urethral reconstruction for traumatic posterior urethral disruption: outcomes of a 25-year experience. J Urol. 2007;178:2006–10.PubMedCrossRefGoogle Scholar
  30. 30.
    Shenfeld OZ, Gofrit ON, Gdor Y. Anastomotic urethroplasty for failed previously treated membranous urethral rupture. Urology. 2004;63:837–40.PubMedCrossRefGoogle Scholar
  31. 31.
    Wang P, Fan M, Zhang Y. Modified urethral pull-though operation for posterior urethral stricture and long-term outcome. J Urol. 2008;180:2479–85.PubMedCrossRefGoogle Scholar
  32. 32.
    Hussain M, Greenwell TJ, Shah J. Long-term results of a self-expanding wallstent in the treatment of urethral stricture. BJU Int. 2004;94:1037–41.PubMedCrossRefGoogle Scholar
  33. 33.
    Eisenberg ML, Elliott SP, McAninch JW. Management of restenosis after urethral stent placement. J Urol. 2008;179:991–5.PubMedCrossRefGoogle Scholar
  34. 34.
    Fisher MB, Santucci RA. Extraction of UroLume endoprosthesis with one-stage urethral reconstruction using buccal mucosa. Urology. 2006;67:9–10.CrossRefGoogle Scholar
  35. 35.
    Gelman J, Rodriguez Jr E. One-stage urethral reconstruction for stricture recurrence after urethral stent placement. J Urol. 2007;177:188–91.PubMedCrossRefGoogle Scholar
  36. 36.
    Elliott SP, Meng MV, Elkin EP. Incidence of urethral stricture after primary treatment for prostate cancer: data from CaPSURE. J Urol. 2007;178:529–34.PubMedCrossRefGoogle Scholar
  37. 37.
    Sullivan L, Williams SG, Tai KH. Urethral stricture following high dose rate brachytherapy for prostate cancer. Radiother Oncol. 2009;91:232–6.PubMedCrossRefGoogle Scholar
  38. 38.
    Elliot SP, McAninch JW, Chi T. Management of severe urethral complications of prostate cancer therapy. J Urol. 2006;176:2508–13.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Department of UrologyThe Detroit Medical CenterDetroitUSA
  2. 2.Department of UrologyDetroit Receiving HospitalDetroitUSA

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