Experience with 170 cases of posterior urethral strictures during 7 years

Various types of urethroplasty and visual urethrotomy should not be regarded as competitive with each other for a particular case of urethral stricture. Rather, they should be regarded as complementary procedures available for the cure of different types of strictures, with each having its indications as well as limitations. In cases of post-traumatic strictures and disruption the best solution is complete excision of the pathological segment and bulboprostatic anastomosis, either through the perineum when prostatic displacement is absent or minimal, or by the transpubic route when the displacement is great. Post-inflammatory strictures should be corrected by a 2-stage urethroplasty with exteriorization of the diseased urethra. Internal visual urethrotomy is reserved for short post-traumatic strictures that are limited in length, circumference and depth. Free skin grafts are best suited to cover small defects after urethroplasty.