Topic: Urethroplasty: Current Techniques and Management of Complications

Urethral reconstruction either primary or due to urethral stricture disease presents constant challenge for all reconstructive urologists. During the past decades, many operative procedures and their modifications for urethroplasty have been published. Hypospadias presents one of the most common congenital anomalies and primary repair of this anomaly depends on type and severity. Urethral stricture disease is generally defined as stenoses that are typically long, involving broad areas of varying spongiofibrosis, and result from inflammation and/or infection, rather than trauma. Despite the fact that urethroplasty may be complex and challenging, it is often treated by health care personnel without the necessary and proper training and knowledge of the current, modern, validated techniques and procedures. Recent surgical techniques should be adopted worldwide, resulting in significant improvement of successful outcomes and simultaneously decreasing the complication rate. Nowadays, most urethral strictures can be reconstructed in a one-stage procedure, leaving some complex cases for a less convenient, but safer, two-stage repair strategy.

The exciting and enjoyable “nature” of reconstructive surgery, in general, and urethral reconstruction, in particular, is the unexpected and unpredictable nature of the stricture and, consequently, the need for the creative combination of different techniques and strategies, often involving tissue transfer procedures, either as grafts or as flaps, for achieving a successful outcome. The popularity of flaps versus grafts has varied over time, and recently, free grafts have been making a comeback, with fewer surgeons using genital flaps.

This special issue contains a number of articles with description of etiology, different aspects, presentations, and treatments of congenital and acquired urethral anomalies making further improvement in understanding and managing this severe surgical condition. Last but not least, a collaborative approach which integrates established, urological practice with the different perspectives of the plastic surgeon is mandatory.

30 Aug 2021