Contemporary Management of Bulbar Urethral Strictures.

Area of Science:

• Urology
• Regenerative Medicine

Background:

• Urethral stricture disease (USD) is a progressive, scar-forming condition affecting the urethra, most commonly the bulbar region.
• Patients present with voiding dysfunction and may develop complications like UTIs, detrusor failure, or renal disease.

Purpose of the Study:

• To review the pathophysiology, diagnostic workup, and evidence-based management of bulbar urethral strictures (BUS).

Main Methods:

• Review of current literature and guidelines on BUS management.
• Analysis of surgical options including endoscopic techniques and urethroplasty.
• Discussion of emerging treatments and future directions.

Main Results:

• Endoscopic treatments are suitable for initial management of short strictures, but repeated use is discouraged.
• Urethroplasty, including anastomotic and tissue substitution techniques, is the gold standard for BUS of all lengths.
• Novel techniques like non-transecting urethroplasty show promise but require further long-term data.

Conclusions:

• Urethroplasty remains the definitive treatment for BUS.
• Future research may focus on tissue-engineered grafts and anti-scarring agents to improve USD management.