[Management of urethral strictures: practical guidelines].

Area of Science:

• Urology
• Surgical Innovation

Background:

• Urethral strictures require precise diagnosis of location and length for effective treatment.
• Current diagnostic methods and treatment limitations necessitate improved management strategies.

Purpose of the Study:

• To outline the optimal diagnostic approach for urethral strictures.
• To delineate appropriate treatment modalities based on stricture characteristics, focusing on recurrence rates and long-term success.

Main Methods:

• Retrograde urethrography, potentially combined with voiding cystourethrography, for precise anatomical assessment.
• Evaluation of endoscopic treatment for short-segment bulbar strictures (<1.5 cm).
• Assessment of open urethroplasty for long-segment or recurrent strictures, emphasizing recurrence-free survival.

Main Results:

• Retrograde urethrography is identified as the optimal diagnostic tool.
• Endoscopic treatment is associated with high recurrence rates for longer or recurrent strictures.
• Open urethroplasty demonstrates superior results for complex strictures, with careful postoperative management being key.

Conclusions:

• Precise diagnosis using retrograde urethrography is essential for guiding urethral stricture treatment.
• Open urethroplasty offers the best chance for recurrence-free survival in long or recurrent urethral strictures.
• Optimal postoperative care is critical for successful outcomes following open urethroplasty.