Management of panurethral strictures

INTRODUCTION: Treatment of panurethral stricture is considered a surgical challenge. We searched the literature to present a comprehensive review. MATERIALS AND METHODS: A review of literature was performed using MEDLINE/PubMed database using terms “urethral stricture” and “urethroplasty”. Only articles published between 1990 and 2009 and written in English language were included in the review. RESULTS: The main causes of panurethral strictures are previous catheterization, urethral surgery, and lichen sclerosus. The treatment of each individual case has to be tailored according to the etiology, history of previous urethral surgeries, availability of local tissues for flap harvesting, availability of appropriate donor tissue, and the expertise of the treating surgeon. In patients with complicated strictures, previously failed urethroplasties and in patients with poor quality of urethral plate two-stage surgery is a better option. In all other situations, either a flap or graft urethroplasty or if adequate tissue is not available then combination of flap and graft gives reasonable success rates. CONCLUSIONS: Panurethral strictures are relatively less common. For successful results, the surgeon should be experienced and should be familiar with all the treatment modalities.