Patient Selection for Urethroplasty Technique: Excision and Primary Reanastomosis Versus Graft

There are many management options for patients with urethral stricture disease. Regarding strictures of the bulbar urethra, ideal management strategies remain controversial. This article reviews important anatomic principles for surgeons to consider when repairing bulbar urethral strictures. Specific presenting features of a bulbar urethral stricture that can serve as a guide for the optimal surgical approach are described. Patient characteristics that are important and may have an impact on the outcome of repair are discussed. The optimal repair of a bulbar urethral stricture should be guided by anatomic principles and scientific evidence, leaving room for individualized therapy and surgeon preference.